Oral presentation | Open | Published:
Lessons to be learned: best and worst results from a 7 years old clinical database of scoliosis patients
Scoliosisvolume 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.
Negrini S, Atanasio S, Fusco C, Zaina F: Effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises) based on SOSORT management criteria: results according to the SRS criteria for bracing studies- SOSORT Award 2009 Winner. Scoliosis. 2009, 4: 19-10.1186/1748-7161-4-19.
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-