Lessons to be learned: best and worst results from a 7 years old clinical database of scoliosis patients
Scoliosis volume 7, Article number: O28 (2012)
Material and methods
All scoliosis patients with more than 2 visits included in a prospective clinical database started in September 2003 were reviewed on August 31st 2010. A cut-off of 20 degrees (improvement or worsening) from the first observation was used to select patients. Patients were analysed for diagnosis, morphology, Cobb angle at start, curve improved/worsened, treatment, gender, Body Mass Index, clinical parameters.
Out of 1886 consecutive patients (TP), 62 (3.3%) changed 20° or more: 26 (1.4%) improved (range 20-34°) (IP), 36 (1.9%) progressed (20-60°) (PP).
Females prevailed in IP and low BMI in PP. In PP prevailed juveniles (35% vs 15%-23.8% in IP-TP); conversely, secondary scoliosis prevailed in both PP and IP (25%-15% respectively vs 1.9% in TP). In IP there were only patients who started over 30° Cobb (100%), while in PP 47% started between 10 and 19°; corresponding percentages in TP were 33.9% and 28.5% respectively. Diagnosis of thoracolumbar single curve was the most common in IP (46% vs 22.1% in TP), while double in PP (67% vs 49.8% in TP). Curves improved were thoracolumbar (IP: 58%), worsened thoracic (PP: 78%). Only patients who had a good or optimum treatment improved, but this was true also in 56% of progressed.
Since these results are not similar to what would be expected according to the known natural history, conservative treatment appears able to change it.
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Negrini S, Grivas TB, Kotwicki T, Rigo M, Zaina F: Guidelines on "Standard of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research": SOSORT Consensus 2008. Scoliosis. 2009, 4 (1): 2-
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Negrini, S., Donzelli, S. & Zaina, F. Lessons to be learned: best and worst results from a 7 years old clinical database of scoliosis patients. Scoliosis 7 (Suppl 1), O28 (2012). https://doi.org/10.1186/1748-7161-7-S1-O28