- Oral presentation
- Open Access
Stabilization of progressive thoracic adolescent idiopathic scoliosis using brace treatment and DoboMed physiotherapy
© Durmala et al; licensee BioMed Central Ltd. 2009
- Published: 14 December 2009
- Axial Rotation
- Adolescent Idiopathic Scoliosis
- Idiopathic Scoliosis
- Cobb Angle
- Thoracic Curvature
Conservative management of progressive idiopathic scoliosis, consisting of bracing and physiotherapy, aims to stabilize the curvature during rapid adolescent growth. Prospective study using pre-defined inclusion criteria is a method of objective verification of this treatment.
The aim of this study was to prospectively evaluate patients with progressive idiopathic scoliosis managed with Cheneau brace and DoboMed physiotherapy.
Twenty-eight consecutive pre-menarchial girls aged 10 to 14 years (mean 12.6 ± 1.1 years) started a treatment plan for thoracic idiopathic scoliosis, having radiological proof of progression. Eighteen of them had an additional structural lumbar curvature. The Cobb angle revealed a magnitude of 21.0° to 40.0° (mean 30.8° ± 5.5°) in the thoracic curvature and 17.0° to 40.0° (mean 29.1° ± 8.2°) in the lumbar curvature. The Perdriolle angle of axial rotation of the apical vertebra was between 2.0° and 28.0° (mean 8.7° ± 5.6°) in the thoracic curvature and between 4.0° and 30.0° (mean 11.9° ± 8.8°) in the lumbar curvature.
A Cheneau brace was ordered to be worn full-time, accompanied by DoboMed daily physiotherapy. The initiation of treatment took place during a 2 week in-patient stay at the rehabilitation department in order to adjust the brace and teach the patient and the parents the technique of exercises. The Cobb angle was measured once a year with an out-of-brace standing radiograph. The duration of therapy is now 30 to 68 months, mean 43 ± 9 months. Eleven patients completed therapy.
The effective time of daily brace wearing was from 8 to 23 hours (mean 12.9 ± 5.0 hours). At the time of the final radiograph the thoracic Cobb angle was between 17.0° and 53.0° (mean 34.0° ± 9.2°), the lumbar Cobb angle was between 15.0° to 51.0° (mean 29.2° ± 10.4°). Three patients (11%) exceeded the limit of a 50° Cobb angle, and were considered to be surgical patients: two in the thoracic and one in the lumbar curvature. Stabilization of the Perdriolle angle of axial rotation was noted: 0.0° to 28.0° (mean 10.5° ± 7.0°) in the thoracic curvature and 2.0° to 33.0° (mean 13.4° ± 9.2°) in the lumbar curvature.
Stabilization of progressive thoracic scoliosis during the period of rapid adolescent growth was achieved in 89% of girls using the brace and specific physiotherapy.
This article is published under license to BioMed Central Ltd.