scholarly journals Treatment of infantile idiopathic scoliosis using a novel thoracolumbosacral orthosis: a case report

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Jeb. McAviney ◽  
Benjamin T. Brown
Keyword(s):  
Idiopathic Scoliosis ◽  
Casting Process ◽  
Thoracic Scoliosis ◽  
Recommended Treatment ◽  
Serial Casting ◽  
Angle Difference ◽  
Part Time ◽  
Infantile Idiopathic Scoliosis ◽  
Time Basis

Abstract Background The recommended treatment for mild to moderate infantile idiopathic scoliosis curves involves serial casting. There are concerns, however, regarding the safety of repeated casting in very young children owing to the requirement for anesthetization during the casting process. Very little research has been conducted on the influence of bracing as an initial treatment for scoliosis in this age group. This report details the successful treatment of a large thoracic curve using a thoracolumbosacral orthosis in an infant diagnosed with infantile idiopathic scoliosis. Case presentation The Dutch-Australian patient presented at 11 weeks of age with a 44° thoracic scoliosis and a rib vertebral angle difference of 14°. The history and physical examination failed to reveal a cause of the curvature, and a diagnosis of infantile idiopathic scoliosis was made. The patient was prescribed a thoracolumbosacral orthosis (ScoliBrace) to be worn on a part-time basis for a period of 8 months. At the end of the bracing program, the patient’s curve had been reduced to 7° and a rib–vertebral angle difference of 0°. A final follow-up of the patient at 2 years after the cessation of treatment revealed no evidence of scoliosis. The parents were compliant with the bracing protocol and reported that the treatment was tolerated by the infant. Conclusion The use of an orthosis as a standalone treatment in this patient resulted in significant reduction in a large thoracic scoliosis. Based on the results witnessed in this patient, further investigation into bracing as an alternative to casting is warranted.

scholarly journals Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986001 ◽  
Author(s):  
Søren Ohrt-Nissen ◽  
Markus Lastikka ◽  
Thomas Borbjerg Andersen ◽  
Ilkka Helenius ◽  
Martin Gehrchen
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Group Versus ◽  
Primary Outcome Measure ◽  
Full Time ◽  
Main Thoracic ◽  
Part Time ◽  
Boston Brace ◽  
Main Curve

Purpose: To compare treatment efficacy between the Boston full-time brace and the Providence part-time brace in main thoracic adolescent idiopathic scoliosis (AIS). Methods: Patients were treated with either the Boston brace ( n = 37) or the Providence brace ( n = 40). Inclusion criteria were Risser grade ≤2, major curve between 25° and 40° with the apex of the curve between T7 and T11 vertebrae. Two-year follow-up was available in all patients unless brace treatment had reached endpoint. The primary outcome measure was main curve progression to ≥45°. Results: Median age was 12.6 years and median treatment length at follow-up was 25 months (interquartile range (IQR): 18–32)) with no difference between the groups ( p ≥ 0.116). Initial median main Cobb angle was 29° (IQR: 27–33) and 36° (IQR: 33–38) in the Boston and Providence groups, respectively ( p < 0.001). At follow-up, 13 patients (35%) had progressed to ≥45° in the Boston group versus 16 patients (40%) in the Providence group ( p = 0.838). Twenty-three patients (62%) had progressed by more than 5° in the Boston group versus 22 patients (55%) in the Providence group ( p = 0.685). The secondary thoracolumbar/lumbar curve progressed by more than 5° in 14 (38%) and 18 (45%) in the Boston and Providence groups, respectively ( p = 0.548). Conclusions: Despite a larger initial curve size in the Providence group, progression of more than 5° or to surgical indication area was similar in the Boston group. Our results indicate that nighttime bracing is a viable alternative to full-time bracing also in main thoracic AIS.

scholarly journals Casting in infantile idiopathic scoliosis as a temporising measure: A systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212092533
Author(s):  
Nabil Alassaf ◽  
Anne Tabard-Fougère ◽  
Romain Dayer
Keyword(s):  
Adverse Events ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Meta Analysis ◽  
Skin Irritation ◽  
Mean Difference ◽  
Secondary Outcome ◽  
Serial Casting ◽  
Infantile Idiopathic Scoliosis ◽  
The Mean

Objective: Treatment of infantile idiopathic scoliosis remains vague. Because implantation of temporary telescopic devices carries a high risk of complications, interest in the older technique of serial casting is growing as a temporising measure before invasive procedures. The goal of this review was to meta-analyse studies examining the effect and safety of casting in infantile idiopathic scoliosis. Methods: Two reviewers independently searched for relevant studies in PubMed and Embase databases through November 2018. The studies included were limited to infantile idiopathic scoliosis patients who underwent casting, had a mean Cobb angle of 20 or more and written in English. The methodological quality of the chosen studies was assessed. The primary outcome was the difference in Cobb angle means from before and after casting. The secondary outcome was adverse events of casting. Heterogeneity was explored and a funnel plot was drawn. Results: Of the 366 studies screened, 10 studies were included in the meta-analysis (243 subjects) and all were non-randomised. The casting was consistently associated with a reduction in the mean Cobb angle. The pooled mean difference was 24.85° (95% confidence interval: 19.25 to 30.46, p < 0.001). A number of reversible adverse events were reported, most commonly skin irritation and transient pulmonary symptoms. Heterogeneity between studies was high. In the meta-regression analysis, the starting Cobb angle did not influence Cobb angle change, but there was an inverse correlation between the mean difference in Cobb angle and mean age. Conclusion: Casting seems to be effective and safe in decreasing Cobb angle even in high curve magnitudes. In older patients, casting showed less Cobb angle correction.

scholarly journals TACTIC IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS IN CHILDREN

2010 ◽  
Vol 16 (2) ◽  
pp. 82-85
Author(s):  
S. V. Vissarionov ◽  
A. P. Drozdetsky
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Growth Potential ◽  
Degree Of Deformation ◽  
Thoracic Scoliosis ◽  
Dorsal Instrumentation ◽  
Thoracic Idiopathic Scoliosis

The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb) are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI). Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.

scholarly journals SURGICAL TREATMENT OF CHILDREN WITH IDIOPATHIC SCOLIOSIS OF LENKE TYPE I WITH THE USE OF TOTAL TRANSPEDICULAR FIXATION

2014 ◽  
Vol 2 (2) ◽  
pp. 3-8 ◽  
Author(s):  
Sergei Valentinovich Vissarionov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Sergei Mikhailovich Belyanchikov ◽  
Vladislav Valerievich Murashko ◽  
Kirill Aleksandrovich Kartavenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Type I ◽  
Thoracic Scoliosis ◽  
Transpedicular Fixation ◽  
Loss Of Correction ◽  
Vertebral Bodies

The purpose of the study. To assess the results of surgical treatment in children with idiopathic scoliosis of thoracic localization. Material and methods. We operated 56 patients aged from 13 to 18 years old with a level of deformity 40-136° according to Cobb. Surgical correction of the deformity was performed with three tactical options using Cotrel-Dubousset dorsal instrumentation. Results. In idiopathic thoracic scoliosis the operating correction ranged from 48 to 100 %. Loss of correction in the follow-up period from 1 year to 3.5 years was 0-7 %. Conclusion. Surgical treatment of idiopathic thoracic scoliosis should be individualized. Application of multisupporting transpedicular metal constructions allows to increase the degree of deformity correction, to perform true derotation of vertebral bodies on top of curvature and to save the result achieved in the postoperative period.

Serial Casting for Infantile Idiopathic Scoliosis

2017 ◽  
Vol 37 (5) ◽  
pp. 311-316 ◽  
Author(s):  
Justin Iorio ◽  
Giuseppe Orlando ◽  
Chris Diefenbach ◽  
John P. Gaughan ◽  
Amer F. Samdani ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Serial Casting ◽  
Infantile Idiopathic Scoliosis

Upper instrumented vertebra to the right of the lowest instrumented vertebra as a predictor of an increase in the main thoracic curve after selective posterior fusion for the thoracolumbar/lumbar curve in Lenke type 5C adolescent idiopathic scoliosis: multicenter study on the relationship between fusion area and surgical outcome

2019 ◽  
Vol 31 (6) ◽  
pp. 857-864 ◽  
Author(s):  
Hiroki Oba ◽  
Jun Takahashi ◽  
Sho Kobayashi ◽  
Tetsuro Ohba ◽  
Shota Ikegami ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Posterior Fusion ◽  
Main Thoracic ◽  
Lowest Instrumented Vertebra ◽  
Line Tilt ◽  
The Right ◽  
Upper Instrumented Vertebra

OBJECTIVEUnfused main thoracic (MT) curvatures occasionally increase after selective thoracolumbar/lumbar (TL/L) fusion. This study sought to identify the predictors of an unacceptable increase in MT curve (UIMT) after selective posterior fusion (SPF) of the TL/L curve in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS).METHODSForty-eight consecutive patients (44 females and 4 males, mean age 15.7 ± 2.5 years, range 13–24 years) with Lenke type 5C AIS who underwent SPF of the TL/L curve were analyzed. The novel “Shinshu line” (S-line) was defined as a line connecting the centers of the concave-side pedicles of the upper instrumented vertebra (UIV) and lowest instrumented vertebra (LIV) on preoperative radiographs. The authors established an S-line tilt to the right as S-line positive (S-line+, i.e., the UIV being to the right of the LIV) and compared S-line+ and S-line− groups for thoracic apical vertebral translation (T-AVT) and MT Cobb angle preoperatively, early postoperatively, and at final follow-up. The predictors for T-AVT > 20 mm at final follow-up were evaluated as well. T-AVT > 20 mm was defined as a UIMT.RESULTSAmong the 48 consecutively treated patients, 26 were S-line+ and 22 were S-line−. At preoperative, early postoperative, and final follow-up a minimum of 2 years later, the mean T-AVT was 12.8 mm (range −9.3 to 32.8 mm), 19.6 mm (range −13.0 to 41.0 mm), and 22.8 mm (range −1.9 to 68.7 mm) in the S-line+ group, and 10.8 mm (range −5.1 to 27.3 mm), 16.2 mm (range −11.7 to 42.1 mm), and 11.0 mm (range −6.3 to 26.9 mm) in the S-line− group, respectively. T-AVT in S-line+ patients was significantly larger than that in S-line− patients at the final follow-up. Multivariate analysis revealed S-line+ (odds ratio [OR] 23.8, p = 0.003) and preoperative MT Cobb angle (OR 7.9, p = 0.001) to be predictors of a UIMT.CONCLUSIONSS-line+ was defined as the UIV being to the right of the LIV. T-AVT in the S-line+ group was significantly larger than in the S-line− group at the final follow-up. S-line+ status and larger preoperative MT Cobb angle were independent predictors of a UIMT after SPF for the TL/L curve in patients with Lenke type 5C AIS. Surgeons should consider changing the UIV and/or LIV in patients exhibiting S-line+ during preoperative planning to avoid a possible increase in MT curve and revision surgery.

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