The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Ningbo Medical Center Lihuili Eastern Hospital, No. 57 Xingning Road, Ningbo, 315000, China.
J Orthop Surg Res. 2019 Jun 27;14(1):194. doi: 10.1186/s13018-019-1244-4.
Infantile patients with congenital scoliosis (CS) can be confronted with increasing risk of mortality and morbidity. To date, the effectiveness of conservative treatment in CS has not been sufficiently investigated. We aimed to evaluate the bracing outcome in patients with CS and to investigate whether wearing brace can effectively delay the surgical procedures.
A total of 39 braced CS patients including 25 boys and 14 girls were reviewed for the eligibility to be included in this study. Radiographic parameters including curve magnitude and T1 to T12 height were evaluated for each patient at the initiation of the treatment and at the final follow-up (FU), respectively. Duration of the follow-up and requirement of surgical interventions were also recorded. The student t test was used to compare the radiographic parameters between the initial visit and the last FU.
The mean initial age at bracing was 4.1 ± 2.3 years, and 7.5 ± 1.8 brace modifications were performed during a mean FU period of 42.1 ± 26.5 months. The mean curve magnitude before bracing was 44.1 ± 12.2°, which was corrected to 41.3 ± 13.5° at the final visit (p = 0.33). T1-T12 height increased from 13.4 ± 2.5 to 17.1 ± 2.8 cm during the treatment (P < 0.001). Nine patients underwent surgical intervention due to the curve progression more than 5°, with the time of surgery delayed for 32.1 ± 18.2 months.
Brace treatment is an effective time-buying modality for CS patients, which may help maintain the body growth and delay the surgical intervention.
患有先天性脊柱侧凸(CS)的婴儿患者可能面临更高的死亡率和发病率。迄今为止,CS 的保守治疗效果尚未得到充分研究。我们旨在评估 CS 患者支具治疗的效果,并研究支具是否能有效延缓手术。
共对 39 名接受支具治疗的 CS 患儿进行了评估,其中男 25 例,女 14 例。分别在治疗开始时和最后随访时(FU)评估每个患者的影像学参数,包括曲度大小和 T1 至 T12 高度。还记录了随访时间和手术干预的要求。采用学生 t 检验比较初始就诊时和最后 FU 时的影像学参数。
支具治疗的平均初始年龄为 4.1±2.3 岁,平均随访 42.1±26.5 个月期间进行了 7.5±1.8 次支具调整。支具治疗前的平均曲线幅度为 44.1±12.2°,最后一次随访时校正为 41.3±13.5°(p=0.33)。T1-T12 高度从治疗前的 13.4±2.5cm 增加到治疗后的 17.1±2.8cm(P<0.001)。9 名患者因曲线进展超过 5°而接受手术干预,手术时间延迟 32.1±18.2 个月。
支具治疗是 CS 患者的一种有效时间延迟方法,有助于维持身体生长并延迟手术干预。