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ScoliOlogiC“Chêneau轻量型”支具对脊柱侧弯患者的矫正效果。

Correction effects of the ScoliOlogiC "Chêneau light" brace in patients with scoliosis.

作者信息

Weiss Hans-Rudolf, Werkmann Mario, Stephan Carola

机构信息

Asklepios Katharina Schroth Spinal Deformities Rehabilitation Centre, Korczakstr, 2, D-55566 Bad Sobernheim, Germany.

出版信息

Scoliosis. 2007 Jan 26;2:2. doi: 10.1186/1748-7161-2-2.

Abstract

BACKGROUND

Different bracing concepts are used today for the treatment of scoliosis. The plaster cast method worldwide seems to be the most practiced technique at the moment. CAD (Computer Aided Design) systems are on the market which allow brace adjustments without plaster. The latest development however, is the use of the ScoliOlogiC off the shelf system enabling the orthopaedic technician to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This "Chêneau light" brace, developed according to the Chêneau principle, promises a reduced impediment of quality of life in the brace. However, material reduction should not result in reduced effectiveness. Therefore the primary correction effect in the "Chêneau light" brace has been evaluated and compared with that of other braces used today.

METHODS

The correction effects of the first 81 patients (main diagnosis Adolescent Idiopathic Scoliosis (AIS) [n = 64] or Early Onset Scoliosis (EOS) [n = 15]), treated according to the principle of the "Chêneau light" brace were evaluated after an average treatment time of 6 weeks by a full-body X-ray made in the standing position whilst wearing the brace and compared with the last X-ray before bracing. The average curvature angle of the whole group was 35,6 degrees , the average age was 12,9 years (SD 1,9), average Risser sign was 1,3 (SD 1,5), average Tanner rating 2,75 (SD 0,7).

RESULTS

The Cobb angle in the whole group was reduced by an average of 16,4 degrees , which corresponds to a correction effect of 51%. The differences were highly significant in the T-test (T = 17,4; p < 0,001). The best correction effects reported in literature so far are about 40% in two different studies. The correction effect was highest in lumbar and thoracolumbar curve pattern (62 %; n = 18). In thoracic scoliosis the correction effect was 36 % (n = 41) and in double major curve pattern 50 % (n = 22). The correction effect correlated slightly negative with age (r = -0,24; p = 0,014), negatively with the Risser stage (-0,29; p = 0,0096) and correlated negatively with the Cobb angle measured before treatment (r = -0,43; p < 0,0001).

CONCLUSION

The use of the "Chêneau light" brace leads to correction effects above average when compared to the correction effects of other braces described in literature. The reduction of material seems to affect the desired correction in a positive way.

摘要

背景

如今,不同的支具治疗理念被用于脊柱侧弯的治疗。目前,石膏模型法似乎是全球范围内应用最广泛的技术。市场上已有计算机辅助设计(CAD)系统,可在无需石膏的情况下进行支具调整。然而,最新的进展是使用现成的ScoliOlogiC系统,使骨科技术人员能够通过连接到前后立柱的各种特定型号的外壳构建用于脊柱侧弯矫正的轻型支具。这种根据谢诺原理开发的“轻型谢诺”支具有望减少佩戴支具对生活质量的影响。然而,材料的减少不应导致效果降低。因此,已对“轻型谢诺”支具的初步矫正效果进行了评估,并与当今使用的其他支具进行了比较。

方法

对首批81例患者(主要诊断为青少年特发性脊柱侧弯(AIS)[n = 64]或早发性脊柱侧弯(EOS)[n = 15])进行评估,这些患者按照“轻型谢诺”支具的原理进行治疗,平均治疗6周后,在站立位佩戴支具时进行全身X线检查,并与佩戴支具前的最后一张X线片进行比较。全组平均曲率角为35.6度,平均年龄为12.9岁(标准差1.9),平均里塞尔征为1.3(标准差1.5),平均坦纳分级为2.75(标准差0.7)。

结果

全组的 Cobb 角平均减小了16.4度,相当于矫正效果为51%。在 t 检验中差异具有高度显著性(T = 17.4;p < 0.001)。迄今为止,文献报道的最佳矫正效果在两项不同研究中约为40%。腰椎和胸腰段曲线模式的矫正效果最高(62%;n = 18)。在胸段脊柱侧弯中,矫正效果为36%(n = 41),在双主弯模式中为50%(n = 22)。矫正效果与年龄呈轻度负相关(r = -0.24;p = 0.014),与里塞尔分期呈负相关(-0.29;p = 0.0096),与治疗前测量的 Cobb 角呈负相关(r = -0.43;p < 0.0001)。

结论

与文献中描述的其他支具的矫正效果相比,使用“轻型谢诺”支具可产生高于平均水平的矫正效果。材料的减少似乎对预期的矫正产生了积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d49/1805423/28995cc6c745/1748-7161-2-2-1.jpg

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