Tsaknakis Konstantinos, Braunschweig Lena, Lorenz Heiko M, Hell Anna K
Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Orthopade. 2020 Jan;49(1):59-65. doi: 10.1007/s00132-019-03709-6.
It is understood that an effective brace therapy requires a primary curve angle reduction of 50% after administering the first orthotic brace.
The aim of the study was to determine the efficacy of conservative brace therapy for scoliosis with a curve angle above 20° and to determine possible influencing factors.
The current study included a cohort of 110 scoliosis patients with conservative brace therapy. The development of the scoliotic curve during brace therapy was documented for an average of 40 months. Influencing factors such as the initial Risser sign, age at the start of treatment, gender, curve patterns and body mass index were analyzed.
The collective consisted of 88 patients with idiopathic and 22 with neuromuscular spinal deformities. At the beginning of the brace therapy, the average age was 12.2 ± 2.8 years with a mean scoliosis curve angle of 30.4° ± 12.5°. The primary brace reduced the scoliotic curve by 31% to 20.9°. In children and adolescents with lower maturity status, the success of the brace therapy was greater than in patients with a higher Risser sign. In addition, children with obesity had less success during brace therapy than normal- or underweight children.
The initial curvature correction of 50% required for effective brace therapy could only be achieved in one third of the patients. On average, the correction was 31%.
据了解，有效的支具治疗要求在佩戴首个矫形支具后主弯角度减小50%。
本研究的目的是确定保守支具治疗对侧弯角度大于20°的脊柱侧弯的疗效，并确定可能的影响因素。
本研究纳入了110例接受保守支具治疗的脊柱侧弯患者队列。记录支具治疗期间脊柱侧弯曲线的发展情况，平均记录时长为40个月。分析了诸如初始Risser征、治疗开始时的年龄、性别、侧弯类型和体重指数等影响因素。
该队列包括88例特发性脊柱侧弯患者和22例神经肌肉性脊柱畸形患者。在支具治疗开始时，平均年龄为12.2±2.8岁，平均脊柱侧弯角度为30.4°±12.5°。首个支具使脊柱侧弯曲线减小了31%，降至20.9°。在成熟度较低的儿童和青少年中，支具治疗的成功率高于Risser征较高的患者。此外，肥胖儿童在支具治疗期间的成功率低于正常体重或体重过轻的儿童。
有效支具治疗所需的初始曲率矫正50%仅在三分之一的患者中得以实现。平均矫正率为31%。
