James J I
J Bone Joint Surg Br. 1975 Nov;57(4):422-9.
This is a study of children who first attended as infants with either progressive infantile idiopathic scoliosis or congenital scoliosis. All had a pattern of scoliosis in which early and damaging deterioration is inevitable. The infants were treated from before the age of three, initially by plaster casts and then a Milwaukee brace, followed at about the age of ten by correction and fusion. The cases were then observed to the end of growth or near that point. In the main study there were twelve cases, six of progressive infantile idiopathic scoliosis and six of congenital scoliosis, which were followed through this long period. Only one of the twelve had a curve worse at the end of growth compared with the initial radiograph as an infant; this one curve had increased only 16 degrees in almost as many years. Although small, the series does show that it is nearly always possible to control even the most serious scoliosis in an infant, if it is tackled early and unremittingly. There are supportive studies of children who have partially completed this regime, and interim results in a newer group of children with spina bifida and scoliosis.
这是一项针对首次在婴儿期就因进行性婴儿特发性脊柱侧弯或先天性脊柱侧弯前来就诊的儿童的研究。所有患儿都患有脊柱侧弯,其早期且具有损害性的恶化是不可避免的。这些婴儿在三岁前开始接受治疗,最初采用石膏固定,然后使用密尔沃基支具,大约在十岁时进行矫正和融合。随后对这些病例进行观察,直至生长结束或接近该阶段。在主要研究中,有十二个病例,其中六个是进行性婴儿特发性脊柱侧弯,六个是先天性脊柱侧弯,这些病例经过了很长一段时间的随访。十二例中只有一例在生长结束时的弯曲程度比婴儿期最初的X光片显示的更严重;这条弯曲度在几乎相同的年份里仅增加了16度。尽管样本量较小,但该系列研究确实表明,如果早期且坚持不懈地进行治疗,几乎总能控制住婴儿即使是最严重的脊柱侧弯。对于部分完成该治疗方案的儿童以及一组患有脊柱裂和脊柱侧弯的新患儿的中期结果,也有支持性研究。