采用渐进作用短支具（PASB）治疗患有特发性脊柱侧弯的青春期女性胸腰段曲线：根据脊柱侧弯研究学会（SRS）支具和非手术治疗标准化委员会标准评估结果

Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB): assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria.

作者信息

Aulisa Angelo G, Guzzanti Vincenzo, Galli Marco, Perisano Carlo, Falciglia Francesco, Aulisa Lorenzo

机构信息

Orthopaedic Department, Children's Hospital Bambino Gesù, Institute of Scientific Research, P.zza S. Onofrio, 4 - 00165 Rome, Italy.

University of Cassino, Strada Folcara, 4 - 03043 Cassino (FR), Italy.

出版信息

Scoliosis. 2009 Sep 18;4:21. doi: 10.1186/1748-7161-4-21.

BACKGROUND

The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect.The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB) in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management Standardisation Criteria.

METHODS

Fifty adolescent females (mean age 11.8 +/- 0.5 years) with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 +/- 44.5 months). Antero-posterior radiographs were used to estimate the curve magnitude (CM) and the torsion of the apical vertebra (TA) at 5 time points: beginning of treatment (t1), one year after the beginning of treatment (t2), intermediate time between t1 and t4 (t3), end of weaning (t4), 2-year minimum follow-up from t4 (t5). Three situations were distinguished: curve correction, curve stabilisation and curve progression.The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests.

RESULTS

CM mean value was 29,30 +/- 5,16 SD at t1 and 14,67 +/- 7,65 SD at t5. TA was 12.70 +/- 6,14 SD at t1 and 8,95 +/- 5,82 at t5. The variation between measures of Cobb and Perdriolle degrees at t1,2,3,4,5 and between CM t5-t1 and TA t5-t1 were significantly different.Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients.

CONCLUSION

The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

背景

脊柱侧弯保守治疗的有效性存在争议。一些研究表明支具在阻止曲线进展方面有效，而其他研究则未报告此类效果。本研究的目的是根据脊柱侧弯研究学会（SRS）支具和非手术管理标准化标准委员会的要求，评估渐进式短支具（PASB）对胸腰段曲线的矫正效果。

方法

纳入了50名患有胸腰段曲线且治疗前Risser评分在0至2之间的青春期女性（平均年龄11.8±0.5岁）。最短随访时间为24个月（平均：55.4±44.5个月）。使用前后位X线片在5个时间点评估曲线大小（CM）和顶椎扭转（TA）：治疗开始时（t1）、治疗开始后一年（t2）、t1和t4之间的中间时间（t3）、断奶结束时（t4）、从t4开始的2年最短随访（t5）。区分了三种情况：曲线矫正、曲线稳定和曲线进展。使用Kruskal Wallis和Spearman等级相关检验作为统计检验。

结果

CM在t1时的平均值为29.30±5.16标准差，在t5时为14.67±7.65标准差。TA在t1时为12.70±6.14标准差，在t5时为8.95±5.82。t1、2、3、4、5时Cobb和Perdriolle度数测量值之间以及CM t5 - t1和TA t5 - t1之间的差异具有统计学意义。94%的患者实现了曲线矫正，而6%的患者实现了曲线稳定。