Zaborowska-Sapeta Katarzyna, Kowalski Ireneusz M, Kotwicki Tomasz, Protasiewicz-Fałdowska Halina, Kiebzak Wojciech
Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland.
Scoliosis. 2011 Jan 25;6(1):2. doi: 10.1186/1748-7161-6-2.
Progressive idiopathic scoliosis can negatively influence the development and functioning of 2-3% of adolescents, with health consequences and economic costs, placing the disease in the centre of interest of the developmental medicine. The aim of this study was to evaluate the effectiveness of Chêneau brace in the management of idiopathic scoliosis.
A prospective observational study according to SOSORT and SRS recommendations comprised 79 patients (58 girls and 21 boys) with progressive idiopathic scoliosis, treated with Chêneau brace and physiotherapy, with initial Cobb angle between 20 and 45 degrees, no previous brace treatment, Risser 4 or more at the final evaluation and minimum one year follow-up after weaning the brace. Achieving 50° of Cobb angle was considered surgical recommendation.
At follow-up 20 patients (25.3%) improved, 18 patients (22.8%) were stable, 31 patients (39.2%) progressed below 50 degrees and 10 patients (12.7%) progressed beyond 50 degrees (2 of these 10 patients progressed beyond 60 degrees). Progression concerned the younger and less skeletally mature patients.
Conservative treatment with Chêneau orthosis and physiotherapy was effective in halting scoliosis progression in 48.1% of patients. The results of this study suggest that bracing is effective in reducing the incidence of surgery in comparison with natural history.
进行性特发性脊柱侧弯会对2%-3%的青少年的发育和功能产生负面影响,带来健康问题和经济成本,使该疾病成为发育医学关注的焦点。本研究的目的是评估施诺(Chêneau)支具治疗特发性脊柱侧弯的有效性。
一项根据脊柱侧弯研究学会(SOSORT)和脊柱侧凸研究学会(SRS)建议开展的前瞻性观察性研究,纳入了79例进行性特发性脊柱侧弯患者(58名女孩和21名男孩),采用施诺支具和物理治疗,初始Cobb角在20度至45度之间,此前未接受过支具治疗,最终评估时Risser分级为4级或更高,且在停用支具后至少随访一年。Cobb角达到50°被视为手术指征。
随访时,20例患者(25.3%)病情改善,18例患者(22.8%)病情稳定,31例患者(39.2%)进展至50度以下,10例患者(12.7%)进展超过50度(这10例患者中有2例进展超过60度)。病情进展的是年龄较小且骨骼成熟度较低的患者。
采用施诺矫形器和物理治疗的保守治疗对48.1%的患者有效阻止了脊柱侧弯进展。本研究结果表明,与自然病程相比,支具治疗在降低手术发生率方面是有效的。