Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Medicine (Baltimore). 2021 Aug 13;100(32):e26822. doi: 10.1097/MD.0000000000026822.
Neuromuscular scoliosis is a common deformity seen in patients with neuromuscular diseases. Although rigid thoracolumbosacral orthosis is the most frequently used brace, it has low compliance rates and can lead to complications including skin ulcers. Thus, alternative methods for treating neuromuscular scoliosis are needed. The purpose of this study is to evaluate the clinical effects of a novel flexible brace to prevent the progression of neuromuscular scoliosis.This study is a prospective observational study. Twenty-three patients with neuromuscular scoliosis were enrolled in the study. Among patients diagnosed with neuromuscular disease, spine radiographs were checked for a neuromuscular scoliosis diagnosis. The participants were treated with a novel flexible brace for 6 months. The control group (n = 46) was selected using propensity score matching method from a clinical data warehouse. The Cobb angle was measured and compared between the study and control groups.In the study group, the average Cobb's angle significantly decreased from 47.22 ± 18.9° to 31.8 ± 20.0 when wearing the flexible brace (P < .001). Thus, the correction rate was 36.9%. The annual progression rate was significantly lower in the study group than in the control group (P < .05).The flexible brace showed a significant correction rate of scoliosis in patients with severe neuromuscular diseases. The flexible brace is an alternative treatment modality for patients with neuromuscular scoliosis. Daily application of the flexible brace during the growing period can reduce the degree of fixed deformity in the long term.
神经肌肉性脊柱侧凸是神经肌肉疾病患者中常见的畸形。虽然刚性胸腰骶矫形器是最常使用的支具,但它的顺应率较低,并可能导致包括皮肤溃疡在内的并发症。因此,需要寻找治疗神经肌肉性脊柱侧凸的替代方法。本研究旨在评估一种新型的灵活支具预防神经肌肉性脊柱侧凸进展的临床效果。
这是一项前瞻性观察性研究。共纳入 23 例神经肌肉性脊柱侧凸患者。在诊断为神经肌肉疾病的患者中,通过脊柱 X 线片检查神经肌肉性脊柱侧凸的诊断。将患者用新型灵活支具治疗 6 个月。对照组(n=46)采用倾向评分匹配方法从临床数据仓库中选择。测量并比较研究组和对照组的 Cobb 角。
在研究组中,佩戴灵活支具后 Cobb 角的平均角度从 47.22±18.9°显著降低至 31.8±20.0°(P<.001),因此矫正率为 36.9%。研究组的年进展率明显低于对照组(P<.05)。
对于严重神经肌肉疾病的患者,灵活支具对脊柱侧凸具有显著的矫正效果。对于神经肌肉性脊柱侧凸患者,灵活支具是一种替代治疗方法。在生长期间每天应用灵活支具可在长期内减少固定性畸形的程度。