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      • Record: found
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      Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB): assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

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          Abstract

          Background

          The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect.

          The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB) in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management Standardisation Criteria.

          Methods

          Fifty adolescent females (mean age 11.8 ± 0.5 years) with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 ± 44.5 months). Antero-posterior radiographs were used to estimate the curve magnitude (C M) and the torsion of the apical vertebra (T A) at 5 time points: beginning of treatment (t 1), one year after the beginning of treatment (t 2), intermediate time between t 1 and t 4 (t 3), end of weaning (t 4), 2-year minimum follow-up from t 4 (t 5). Three situations were distinguished: curve correction, curve stabilisation and curve progression.

          The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests.

          Results

          C M mean value was 29,30 ± 5,16 SD at t 1 and 14,67 ± 7,65 SD at t 5. T A was 12.70 ± 6,14 SD at t 1 and 8,95 ± 5,82 at t 5. The variation between measures of Cobb and Perdriolle degrees at t 1,2,3,4,5 and between C M t 5-t 1 and T A t 5-t 1 were significantly different.

          Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients.

          Conclusion

          The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

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          Most cited references30

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          The prediction of curve progression in untreated idiopathic scoliosis during growth.

          Eric Carlson, J W Lonstein (1984)
          We reviewed the cases of 727 patients with idiopathic scoliosis in whom the initial curve measured from 5 to 29 degrees. The patients were followed either to the end of skeletal growth or until the curve progressed. One hundred and sixty-nine patients (23.2 per cent) showed progression of the curve. The incidence of curve progression was found to be related to the pattern and magnitude of the curve, the patient's age at presentation, the Risser sign, and the patient's menarchal status. We found no correlation between progression of the curve and the patient's sex, Harrington factor, rotational prominence, family history, or radiographic measurements. A progression factor was calculated using the three strongest correlations available at initial examination: the magnitude of the curve, the Risser sign, and the patient's chronological age. A graph and nomogram are presented that can serve as a guide for advising patients' families and for planning continuing care.
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            Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society.

            A L Nachemson, Mark Peterson (1995)
            In a prospective study by the Scoliosis Research Society, 286 girls who had adolescent idiopathic scoliosis, a thoracic or thoracolumbar curve of 25 to 35 degrees, and a mean age of twelve years and seven months (range, ten to fifteen years) were followed to determine the effect of treatment with observation only (129 patients), an underarm plastic brace (111 patients), and nighttime surface electrical stimulation (forty-six patients). Thirty-nine patients were lost to follow-up, leaving 247 (86 per cent) who were followed until maturity or who were dropped from the study because of failure of the assigned treatment. The end point of failure of treatment was defined as an increase in the curve of at least 6 degrees, from the time of the first roentgenogram, on two consecutive roentgenograms. As determined with use of this end point, treatment with a brace failed in seventeen of the 111 patients; observation only, in fifty-eight of the 129 patients; and electrical stimulation, in twenty-two of the forty-six patients. According to survivorship analysis, treatment with a brace was associated with a success rate of 74 per cent (95 per cent confidence interval, 52 to 84) at four years; observation only, with a success rate of 34 per cent (95 per cent confidence interval, 16 to 49); and electrical stimulation, with a success rate of 33 per cent (95 per cent confidence interval, 12 to 60).(ABSTRACT TRUNCATED AT 250 WORDS)
            Article 0 comments Cited 110 times – based on 0 reviews     Review now
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              Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error.

              R Morrissy, D Kehl, Robert Cowie … (1990)
              To quantitate the intrinsic error in measurement, fifty anteroposterior radiographs of patients who had scoliosis were each measured on six separate occasions by four orthopaedic surgeons using the Cobb method. For the first two measurements (Set I), each observer selected the end-vertebrae of the curve; for the next two measurements (Set II), the end-vertebrae were pre-selected and constant. The last two measurements (Set III) were obtained in the same manner as Set II, except that each examiner used the same protractor rather than the one that he carried with him. The pooled results of all four observers suggested that the 95 per cent confidence limit for intraobserver variability was 4.9 degrees for Set I, 3.8 degrees for Set II, and 2.8 degrees for Set III. The interobserver variability was 7.2 degrees for Set I and 6.3 degrees for Sets II and III. The mean angles differed significantly between observers, but the difference was smaller when the observers used the same protractor.
              Article 0 comments Cited 104 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Scoliosis
                Title: Scoliosis
                Publisher: BioMed Central
                ISSN (Electronic): 1748-7161
                Publication date Collection: 2009
                Publication date (Electronic): 18 September 2009
                Volume: 4
                Page: 21
                Affiliations
                [1 ]Orthopaedic Department, Children's Hospital Bambino Gesù, Institute of Scientific Research, P.zza S. Onofrio, 4 - 00165 Rome, Italy
                [2 ]University of Cassino, Strada Folcara, 4 - 03043 Cassino (FR), Italy
                [3 ]Orthopaedic Department, Children's Hospital Bambino Gesù, Institute of Scientific Research, P.zza S. Onofrio, 4 - 00165 Rome, Italy
                [4 ]Department of Orthopaedics, "A. Gemelli" Hospital, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1 - 00168, Rome, Italy
                Article
                Publisher ID: 1748-7161-4-21
                DOI: 10.1186/1748-7161-4-21
                PMC ID: 2754424
                PubMed ID: 19765288
                SO-VID: bcbf411d-abfc-4afb-9ec5-4dfcfc8ea408
                Copyright © Copyright © 2009 Aulisa et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 April 2009
                Date accepted : 18 September 2009
                Categories
                Subject: Research

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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