Diedrich O, von Strempel A, Schloz M, Schmitt O, Kraft C N
Department of Orthopaedic Surgery, University of Bonn, Germany.
J Bone Joint Surg Br. 2002 Sep;84(7):1030-5. doi: 10.1302/0301-620x.84b7.13005.
Of 42 patients with resolving infantile idiopathic scoliosis, 34 were followed up for more than 25 years. Twenty had been primarily treated in a plaster bed and 14 by physiotherapy. The mean angle of the curve at presentation was 17 degrees and at follow-up it was 5 degrees. No patient had significant progression of the scoliosis during the growth spurt. When adults few had back pain or an increased disability score and there was no interference with work or social activities. The rib-vertebra angle difference proved to be an essential radiological sign when distinguishing resolving from progressive infantile idiopathic scoliosis. There was no advantage of plaster over physiotherapy with regard to either the time to resolution or the functional outcome. Treatment of resolving infantile idiopathic scoliosis in a plaster bed is therefore now outdated.
在42例正在好转的婴儿特发性脊柱侧凸患者中,34例接受了超过25年的随访。20例最初采用石膏床治疗,14例采用物理治疗。就诊时侧弯的平均角度为17度,随访时为5度。没有患者在生长突增期出现脊柱侧凸的显著进展。成年后,很少有人有背痛或残疾评分增加,且工作或社交活动未受影响。在区分好转型与进展型婴儿特发性脊柱侧凸时,肋椎角差被证明是一个重要的放射学征象。在好转时间或功能结局方面,石膏治疗并不优于物理治疗。因此,现在在石膏床中治疗好转型婴儿特发性脊柱侧凸已过时。