Dept. Of Orthopaedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
Medical College of Wisconsin, Milwaukee, WI, USA.
Stud Health Technol Inform. 2021 Jun 28;280:187-191. doi: 10.3233/SHTI210464.
Elongation-de-rotation-flexion (EDF) casting is a popular treatment for early-onset-scoliosis (EOS). However, casting every 2 to 3 months using general anesthesia may affect cognitive function.[1,2] Aims of this study: 1) to develop a new orthosis for EOS treatment based on EDF technique (EDFO) and traction frame; 2) to evaluate emerging radiographic results from treatment. Mehta's EDF serial casting method and AMIL traction frame were used to manually correct the spine for 3D trunk scan. Afterward, a digital spinal model was created and helped design the EDFO with CAD/CAM technology. Radiographic measurements included Cobb angle, RVAD, and thoracic height and width. Six patients (2 girls; 4 boys) diagnosed with idiopathic EOS were enrolled in the study. EDFO was applied at mean 36.5 months of age, after final EDF casting. The average major Cobb angle stabilized after treatment. Average RVAD increased. The average normalized thoracic width at last EDFO out-of-brace was less than prior to EDFO. The new asymmetric EDFO offers an alternative to serial casting and TLSO. EDFO is considered a cost-effective, safer, more breathable, removable, and less invasive modality.
延-旋-弯（EDF）矫形石膏固定是治疗早发性脊柱侧凸（EOS）的常用方法。然而，每 2-3 个月使用全身麻醉进行石膏固定可能会影响认知功能。[1,2]本研究的目的：1）基于 EDF 技术（EDFO）和牵引框架开发一种新的治疗 EOS 的矫形器；2）评估治疗中出现的新的影像学结果。采用 Mehta 的 EDF 连续石膏固定方法和 AMIL 牵引框架手动矫正 3D 躯干扫描的脊柱。之后，创建数字脊柱模型，并借助 CAD/CAM 技术帮助设计 EDFO。影像学测量包括 Cobb 角、RVAD 以及胸椎高度和宽度。本研究纳入了 6 名（2 名女孩；4 名男孩）诊断为特发性 EOS 的患者。在最后一次 EDF 石膏固定后，平均 36.5 个月时应用 EDFO。治疗后，平均主要 Cobb 角稳定。RVAD 平均增加。最后一次 EDFO 去除支具时，平均胸椎宽度比 EDFO 之前小。新型非对称 EDFO 为连续石膏固定和 TLSO 提供了另一种选择。EDFO 被认为是一种具有成本效益、更安全、更透气、可移除和微创的治疗方式。
