Trivedi J M, Thomson J D
Department of Orthopaedic Surgery, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA.
J Pediatr Orthop. 2001 May-Jun;21(3):277-80.
Previous studies have reported varying success rates with the use of the Charleston brace in idiopathic scoliosis. However, these studies have included patients from multiple centers, those with double curves, and those still undergoing treatment. This article presents the results of Charleston bracing in 42 skeletally immature patients (Risser 0/1) treated at one institution and followed up for a mean of 3.3 years after brace discontinuation. Selection criteria included a diagnosis of idiopathic scoliosis, Risser stage 0 or 1, at least 10 years of age at the time of bracing, female gender, a single curve between 25 degrees and 40 degrees, and no prior treatment. The average age at the time of bracing was 12.5 years (range 10-15) and the average curve was 30.3 degrees (range 25 degrees -40 degrees ). Outcome was considered a failure if the curve had increased more than 5 degrees at last follow-up, if surgical intervention was required, or if there was a change of orthosis during treatment (e.g., Charleston to Boston). In 25 of the 42 patients (60%), the brace was successful in preventing progression of the curve (mean follow-up 3.4 years; range 1.1-11.7). Thoracic curves had the same success as thoracolumbar and lumbar curves. Based on these results, the authors conclude that the Charleston brace is effective in preventing progression of curve. Proper patient selection is important.
以往的研究报告了使用查尔斯顿支具治疗特发性脊柱侧凸的成功率各不相同。然而,这些研究纳入了来自多个中心的患者、双弯患者以及仍在接受治疗的患者。本文介绍了在一家机构接受治疗的42例骨骼未成熟患者(Risser 0/1)使用查尔斯顿支具的结果,这些患者在停止使用支具后平均随访了3.3年。选择标准包括特发性脊柱侧凸的诊断、Risser分期0或1、支具治疗时年龄至少10岁、女性、单一弯度在25度至40度之间且未接受过先前治疗。支具治疗时的平均年龄为12.5岁(范围10 - 15岁),平均弯度为30.3度(范围25度 - 40度)。如果在最后一次随访时弯度增加超过5度、需要手术干预或在治疗期间更换矫形器(例如,从查尔斯顿支具更换为波士顿支具),则结果被视为失败。在42例患者中的25例(60%),支具成功地防止了弯度进展(平均随访3.4年;范围1.1 - 11.7年)。胸弯与胸腰弯和腰弯的成功率相同。基于这些结果,作者得出结论,查尔斯顿支具在防止弯度进展方面是有效的。正确选择患者很重要。