Pries P, Gayet L E, Clarac J P, Launay L, Brax P
Service d'Orthopédie-Traumatologie adulte et infantile, Hôpital Jean-Bernard, CHRU La Miletrie, Poitiers.
Chir Pediatr. 1990;31(2):119-24.
This work tries to clarify the place which is due to the modified Lyons orthopaedic treatment of scolioses. Actually, nowadays, because of progress in surgery, some people abandon all orthopaedic treatment which caught severe progressive scolioses at the end of the growth period. The study covers 70 patients from a minimum distance of 3 years after the end of orthopaedic treatment. The treatment, in comparison with the classical Lyons treatment has two principle modifications: sequence protocol plaster then corset, purely external, not necessitizing hospitalisation or a stay in a specialised centre; and the use of resine which lightens the plaster. The results are given in angular loss as regards to the end of treatment, according to 3 factors; chronological form of the scoliosis, localization of the scoliosis, degree of the initial curvature. It emerges that in spite of the absence of hospitalisation at the beginning of the treatment, the results are comparable to those in literature (8, 19). We obtained 39 stabilizations of progression, 8 moderate aggravations without ulterior surgery, that is 67% good results. Our study confirms the high failure rate of orthopedic treatment of initial scolioses of 50 degrees and more (50%); compared to initial scolioses of 49 degrees to 20 degrees (29%); of dorsal scolioses (42%) compared to lumbar scolioses (18%); of child scolioses (40%) compared to adolescent scolioses (17%). It leads us to keep the Lyons treatment for progressive scolioses of 25 degrees to 40 degrees, from the start of puberty, or as preparation for surgical treatment.
这项工作试图阐明改良的里昂脊柱侧弯矫形治疗法应有的地位。实际上，如今由于外科手术的进展，一些人摒弃了所有在生长期末期用于治疗严重进展性脊柱侧弯的矫形治疗方法。该研究涵盖了70名患者，自矫形治疗结束后至少随访3年。与传统的里昂治疗法相比，该治疗法有两项主要改进：治疗顺序为石膏然后紧身胸衣，完全是外部治疗，无需住院或在专门中心停留；使用树脂减轻石膏重量。结果以治疗结束时的角度丢失表示，依据三个因素：脊柱侧弯的时间形态、脊柱侧弯的部位、初始弯曲度。结果显示，尽管治疗开始时无需住院，但结果与文献报道相当（8, 19）。我们获得了39例进展稳定，8例中度加重且无需进一步手术，即67%的良好结果。我们的研究证实，50度及以上的初始脊柱侧弯矫形治疗失败率很高（50%）；相比之下，49度至20度的初始脊柱侧弯（29%）；胸段脊柱侧弯（42%）相比腰段脊柱侧弯（18%）；儿童脊柱侧弯（40%）相比青少年脊柱侧弯（17%）。这使我们在青春期开始时，对于25度至40度的进展性脊柱侧弯，保留里昂治疗法，或者作为手术治疗的准备。
