Karol L A
Department of Orthopaedics, Texas Scottish Rite Hospital for Children, Dallas, Texas 75219, USA.
Spine (Phila Pa 1976). 2001 Sep 15;26(18):2001-5. doi: 10.1097/00007632-200109150-00013.
A review of a clinical series was performed.
To assess the effectiveness of orthotic treatment in male patients with idiopathic scoliosis and to compare with published data on female patients.
Although males have been included in bracing studies, the number of males has been small, and there have been no studies of exclusively male braced patients.
The medical records of 112 males with idiopathic scoliosis age > or =10 years who were prescribed orthoses were reviewed to confirm idiopathic etiology, determine the brace prescribed, and estimate compliance. Cobb angles and Risser signs were measured from radiographs at presentation, brace prescription, brace discontinuation, and final follow-up. Progression was defined as an increase in curve magnitude of 6 degrees. Surgical progression was defined as progression to 50 degrees and/or arthrodesis. The average age at brace prescription was 13.9 years, and 66% were Risser 0. Duration of treatment averaged 3.1 years. Curve magnitude at brace prescription averaged 33.1 degrees. The patients were observed an average of 1.2 years after the brace was discontinued.
Progression of 6 degrees occurred in 74% of boys, and 46% reached surgical thresholds. Curve progression was related to immature Risser status but not to age or curve magnitude. Progression to surgery was related to immature Risser status and initial curve magnitude. Curves measuring > or =30 degrees progressed to surgical magnitudes in >50% of patients. Compliance was good in only 38% of patients.
Bracing of male patients with idiopathic scoliosis is ineffective. Curves measuring > or =30 degrees are very likely to progress to surgery, especially in immature patients.
对一组临床病例进行回顾性研究。
评估矫形器治疗男性特发性脊柱侧凸患者的疗效，并与已发表的女性患者数据进行比较。
尽管男性已被纳入支具治疗研究，但男性患者数量较少，且尚无专门针对男性支具治疗患者的研究。
回顾了112例年龄≥10岁的男性特发性脊柱侧凸患者的病历，这些患者均被开具了矫形器，以确认特发性病因、确定所开具的支具类型并评估依从性。在就诊时、开具支具时、停用支具时以及最后随访时，通过X线片测量Cobb角和Risser征。进展定义为侧弯角度增加6度。手术进展定义为侧弯进展至50度和/或发生融合。开具支具时的平均年龄为13.9岁，66%的患者Risser征为0级。治疗时间平均为3.1年。开具支具时的侧弯角度平均为33.1度。在停用支具后，对患者平均观察了1.2年。
74%的男孩侧弯进展了6度，46%达到了手术阈值。侧弯进展与Risser征未成熟状态有关，而与年龄或侧弯角度无关。进展至手术与Risser征未成熟状态和初始侧弯角度有关。角度≥30度的侧弯在超过50%的患者中进展至手术角度。只有38%的患者依从性良好。
对男性特发性脊柱侧凸患者使用支具治疗无效。角度≥30度的侧弯很可能进展至需要手术，尤其是在未成熟患者中。
