Effects of specific physiotherapeutic exercises in a patient with a severe neuromuscular scoliosis with rigid spine syndrome: a case report
© Espinoza and Dockendorff; licensee BioMed Central Ltd. 2014
Published: 4 December 2014
Non-idiopathic Scoliosis account for approximately 20% of scoliosis population and some cases need surgery. Exercises are important for the rehabilitation following fusion.
To show the improvements in the positive sagittal balance and flat back condition in a patient with a severe neuromuscular scoliosis (NMS) with Rigid Spine Syndrome (RSS) treated with specific physiotherapeutic exercises.
A 16-year-old male patient diagnosed with severe NMS with RSS underwent to a posterior spinal fusion from T5 to L1 at 10 years-old. Surgery reduced the Cobb’s angle at the main thoracic, lumbar and the cervical curvature to half. Nonetheless, post-surgery complications appeared: the cervical curvature increased, positive sagittal balance appeared, hyperextension of the neck and head, flat back and kyphosis posture was developed. On October 2013 the patient started a program with specific exercises for scoliosis 2-3 times a week, based on rotational breathing principles from the Schroth method, Pilate’s exercises and physical therapy lumbopelvic stabilization exercises following the standard features of scoliosis rehabilitation schools.
Radiographies and documented pictures were taken at the beginning and at the sixth week of treatment. A comparison of these images shows an improvement in the flat back condition where the lumbar lordosis angle increased and positive sagittal balance was normalized. Currently, the patient is able to maintain this new posture by his own, however, he usually tends to fall into the misalignments postural vicious.
Short term results were observed in a difficult case of scoliosis using a convergent approach of different treatment techniques. Although Cobb’s angle remains, changes are evident at lateral radiography and documented pictures. Specific exercises could be an effective way to maintain or reduce the progression of the positive sagittal balance, improve the flat back condition and quality of life.
- Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O'Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagrasa M, Weiss HR, Zaina F: 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 2012, 7: 1-3. 10.1186/1748-7161-7-1.View ArticleGoogle Scholar
- Rigo MD, Grivas TB: “Rehabilitation schools” for scoliosis thematic series: describing the methods and results. Scoliosis. 2010, 5: 27. 10.1186/1748-7161-5-27.PubMed CentralView ArticlePubMedGoogle Scholar
- Flanigan KM, Kerr L, Bromberg MB, Leonard C, Tsuruda J, Zhang P, Gonzalez-Gomez I, Cohn R, Campbell KP, Leppert M: Congenital muscular dystrophy with rigid spine syndrome: a clinical, pathological, radiological, and genetic study. Ann Neurol. 2000, 47 (2): 152-161. 10.1002/1531-8249(200002)47:2<152::AID-ANA4>3.0.CO;2-U.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.