The effectiveness analysis of serial cast and bracing for progressive early-onset scoliosis
10.3760/cma.j.issn.0253-2352.2019.18.002
- VernacularTitle: 系列石膏及支具治疗进展型早发性脊柱侧凸的疗效分析
- Author:
Haixia LI
1
;
Jigong WU
;
Lizhi SONG
;
Lele ZHANG
;
Jiaxu WANG
;
Bo GAO
;
Jing ZHANG
;
Shuilin SHAO
;
Shibo HUANG
Author Information
1. Department of Orthopedics, the 306th Hospital of PLA, Beijing 100101, China
- Publication Type:Clinical Trail
- Keywords:
Scoliosis;
Orthopedic fixation devices;
Child development
- From:
Chinese Journal of Orthopaedics
2019;39(18):1108-1116
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To define radiographic features that response to serial casting and bracing for progressive early-onset scoliosis (EOS).
Methods:A retrospective study of a total of 20 patients (10 females and 10 males) with complete radiographic data diagnosed as progressive early onset scoliosis treated with serial cast or brace for at least 12 months in the 306th Hospital of PLA from June 2011 to April 2018. Ages at initial diagnosis were all less than 5 years old. They were divided into two groups according to the main curve degree, those with cobbs angles more than 50 degree treated with serial cast, or else with brace. All the cases have radiographs of pretreatment, posttreatment, and last follow-up, and anteroposterior (lateral) film of the full length spine in standing position were taken to evaluate magnitudes and balance of coronal and sagittal malformations. We compared the general data of the two groups by independent sample t test and that of pretreatment, posttreatment and the last follow-up by paired-sample t test.
Results:According to the effective standard of not less than 10 degrees improvement, 9 of them were effective, 4 cast and 5 brace, the effective rates were 44.44% and 45.45%, 3 cases from brace group progressed. The magnitudes of the main curve improved significantly after the first treatment of cast and brace (55.4±24.36 vs 42.35±23.62) degree (t=5.850, P=0.000), and at the last follow up, the curve decreased slightly compared of that before interventions (55.4±24.36 vs 51.8±26.33). The compensatory curves, segmental kyphosis, thoracic kyphosis, lumbar lordosis, balance of both coronal and sagittal also had no significant differences between the primal and the latest follow up. The widths 159.63±19.27 mm, 160.81±14.54 mm, 176.08±28.10 mm (t=3.942, P=0.001; t=-3.096, P=0.006) and heights 153.78±29.24 mm, 161.14±29.53 mm, 175.01±36.91 mm of the thoracic were significantly different between pre-posttreatment and the last follow up (t=-5.950, P=0.000; t=-3.997, P=0.001). Serial cast and brace application can preserve the growth of the thorax.
Conclusion:Serial cast and brace are viable growth friendly methods to deal with progressed EOS, Although a cure improvement cannot be always expected, they can stabilize relatively large curves in young children and may help delay eventual surgical intervention.
