Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Scoliosis | Research article

Brace treatment can serve as a time-buying tactic for patients with congenital scoliosis

Authors: Yuwen Wang, Zongxian Feng, Zhichong Wu, Yong Qiu, Zezhang Zhu, Leilei Xu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Login to get access

Abstract

Background

Infantile patients with congenital scoliosis (CS) can be confronted with increasing risk of mortality and morbidity. To date, the effectiveness of conservative treatment in CS has not been sufficiently investigated. We aimed to evaluate the bracing outcome in patients with CS and to investigate whether wearing brace can effectively delay the surgical procedures.

Methods

A total of 39 braced CS patients including 25 boys and 14 girls were reviewed for the eligibility to be included in this study. Radiographic parameters including curve magnitude and T1 to T12 height were evaluated for each patient at the initiation of the treatment and at the final follow-up (FU), respectively. Duration of the follow-up and requirement of surgical interventions were also recorded. The student t test was used to compare the radiographic parameters between the initial visit and the last FU.

Results

The mean initial age at bracing was 4.1 ± 2.3 years, and 7.5 ± 1.8 brace modifications were performed during a mean FU period of 42.1 ± 26.5 months. The mean curve magnitude before bracing was 44.1 ± 12.2°, which was corrected to 41.3 ± 13.5° at the final visit (p = 0.33). T1-T12 height increased from 13.4 ± 2.5 to 17.1 ± 2.8 cm during the treatment (P < 0.001). Nine patients underwent surgical intervention due to the curve progression more than 5°, with the time of surgery delayed for 32.1 ± 18.2 months.

Conclusions

Brace treatment is an effective time-buying modality for CS patients, which may help maintain the body growth and delay the surgical intervention.
Literature
1.
go back to reference Erol B, Tracy MR, Dormans JP, Zackai EH, Maisenbacher MK, O'Brien ML, Turnpenny PD, Kusumi K. Congenital scoliosis and vertebral malformations: characterization of segmental defects for genetic analysis. J Pediatr Orthop. 2004;24:674–82.CrossRef Erol B, Tracy MR, Dormans JP, Zackai EH, Maisenbacher MK, O'Brien ML, Turnpenny PD, Kusumi K. Congenital scoliosis and vertebral malformations: characterization of segmental defects for genetic analysis. J Pediatr Orthop. 2004;24:674–82.CrossRef
2.
go back to reference Kaspiris A, Grivas TB, Weiss HR. Congenital scoliosis in monozygotic twins: case report and review of possible factors contributing to its development. Scoliosis. 2008;3:17.CrossRef Kaspiris A, Grivas TB, Weiss HR. Congenital scoliosis in monozygotic twins: case report and review of possible factors contributing to its development. Scoliosis. 2008;3:17.CrossRef
3.
go back to reference Nakajima A, Kawakami N, Imagama S, Tsuji T, Goto M, Ohara T. Three-dimensional analysis of formation failure in congenital scoliosis. Spine. 2007;32:562–7.CrossRef Nakajima A, Kawakami N, Imagama S, Tsuji T, Goto M, Ohara T. Three-dimensional analysis of formation failure in congenital scoliosis. Spine. 2007;32:562–7.CrossRef
4.
go back to reference Shahcheraghi GH, Hobbi MH. Patterns and progression in congenital scoliosis. J Pediatr Orthop. 1999;19:766–75.PubMed Shahcheraghi GH, Hobbi MH. Patterns and progression in congenital scoliosis. J Pediatr Orthop. 1999;19:766–75.PubMed
5.
go back to reference Winter RB. Congenital thoracic scoliosis with unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs with severe progression after posterior fusion at age 2: 40-year follow-up after revision anterior and posterior surgery at age 8. Spine. 2012;37:E507–10.CrossRef Winter RB. Congenital thoracic scoliosis with unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs with severe progression after posterior fusion at age 2: 40-year follow-up after revision anterior and posterior surgery at age 8. Spine. 2012;37:E507–10.CrossRef
6.
go back to reference Tanaka T. A study of the progression of congenital scoliosis in non-operated cases. Nihon Seikeigeka Gakkai Zasshi. 1988;62:9–22.PubMed Tanaka T. A study of the progression of congenital scoliosis in non-operated cases. Nihon Seikeigeka Gakkai Zasshi. 1988;62:9–22.PubMed
7.
go back to reference Nasca RJ, Stilling FH 3rd, Stell HH. Progression of congenital scoliosis due to hemivertebrae and hemivertebrae with bars. J Bone Joint Surg Am. 1975;57:456–66.CrossRef Nasca RJ, Stilling FH 3rd, Stell HH. Progression of congenital scoliosis due to hemivertebrae and hemivertebrae with bars. J Bone Joint Surg Am. 1975;57:456–66.CrossRef
8.
go back to reference McMaster MJ, Ohtsuka K. The natural history of congenital scoliosis. A study of two hundred and fifty-one patients. J Bone Joint Surg Am. 1982;64:1128–47.CrossRef McMaster MJ, Ohtsuka K. The natural history of congenital scoliosis. A study of two hundred and fifty-one patients. J Bone Joint Surg Am. 1982;64:1128–47.CrossRef
9.
go back to reference Marks DS, Qaimkhani SA. The natural history of congenital scoliosis and kyphosis. Spine. 2009;34:1751–5.CrossRef Marks DS, Qaimkhani SA. The natural history of congenital scoliosis and kyphosis. Spine. 2009;34:1751–5.CrossRef
10.
go back to reference Cao J, Zhang XJ, Sun N, Sun L, Guo D, Qi XY, Bai YS, Sun BS. The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience. J Orthop Surg Res. 2017;12:56.CrossRef Cao J, Zhang XJ, Sun N, Sun L, Guo D, Qi XY, Bai YS, Sun BS. The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience. J Orthop Surg Res. 2017;12:56.CrossRef
11.
go back to reference Demirkiran HG, Bekmez S, Celilov R, Ayvaz M, Dede O, Yazici M. Serial derotational casting in congenital scoliosis as a time-buying strategy. J Pediatr Orthop. 2015;35:43–9.CrossRef Demirkiran HG, Bekmez S, Celilov R, Ayvaz M, Dede O, Yazici M. Serial derotational casting in congenital scoliosis as a time-buying strategy. J Pediatr Orthop. 2015;35:43–9.CrossRef
12.
go back to reference Atici Y, Akman YE, Balioglu MB, Erdogan S. A comparison of the effects of two different techniques on shoulder balance in the treatment of congenital scoliosis: vertical expandable prosthetic titanium rib and dual growing rod. J Craniovertebr Junction Spine. 2015;6:190–4.CrossRef Atici Y, Akman YE, Balioglu MB, Erdogan S. A comparison of the effects of two different techniques on shoulder balance in the treatment of congenital scoliosis: vertical expandable prosthetic titanium rib and dual growing rod. J Craniovertebr Junction Spine. 2015;6:190–4.CrossRef
13.
go back to reference Yazici M, Emans J. Fusionless instrumentation systems for congenital scoliosis: expandable spinal rods and vertical expandable prosthetic titanium rib in the management of congenital spine deformities in the growing child. Spine. 2009;34:1800–7.CrossRef Yazici M, Emans J. Fusionless instrumentation systems for congenital scoliosis: expandable spinal rods and vertical expandable prosthetic titanium rib in the management of congenital spine deformities in the growing child. Spine. 2009;34:1800–7.CrossRef
14.
go back to reference Louis ML, Gennari JM, Loundou AD, Bollini G, Bergoin M, Bernard JC, Biot B, Bonnard C, Clement JL, Garin C, et al. Congenital scoliosis: a frontal plane evaluation of 251 operated patients 14 years old or older at follow-up. Orthop Traumatol Surg Res. 2010;96:741–7.CrossRef Louis ML, Gennari JM, Loundou AD, Bollini G, Bergoin M, Bernard JC, Biot B, Bonnard C, Clement JL, Garin C, et al. Congenital scoliosis: a frontal plane evaluation of 251 operated patients 14 years old or older at follow-up. Orthop Traumatol Surg Res. 2010;96:741–7.CrossRef
15.
go back to reference Smith JR, Samdani AF, Pahys J, Ranade A, Asghar J, Cahill P, Betz RR. The role of bracing, casting, and vertical expandable prosthetic titanium rib for the treatment of infantile idiopathic scoliosis: a single-institution experience with 31 consecutive patients. Clinical article. J Neurosurg Spine. 2009;11:3–8.CrossRef Smith JR, Samdani AF, Pahys J, Ranade A, Asghar J, Cahill P, Betz RR. The role of bracing, casting, and vertical expandable prosthetic titanium rib for the treatment of infantile idiopathic scoliosis: a single-institution experience with 31 consecutive patients. Clinical article. J Neurosurg Spine. 2009;11:3–8.CrossRef
16.
go back to reference Pratt RK, Webb JK, Burwell RG, Cummings SL. Luque trolley and convex epiphysiodesis in the management of infantile and juvenile idiopathic scoliosis. Spine. 1999;24:1538–47.CrossRef Pratt RK, Webb JK, Burwell RG, Cummings SL. Luque trolley and convex epiphysiodesis in the management of infantile and juvenile idiopathic scoliosis. Spine. 1999;24:1538–47.CrossRef
17.
go back to reference Canavese F, Botnari A, Dimeglio A, Samba A, Pereira B, Gerst A, Granier M, Rousset M, Dubousset J. Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results. Eur Spine J. 2016;25:487–94.CrossRef Canavese F, Botnari A, Dimeglio A, Samba A, Pereira B, Gerst A, Granier M, Rousset M, Dubousset J. Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results. Eur Spine J. 2016;25:487–94.CrossRef
18.
go back to reference Iorio J, Orlando G, Diefenbach C, Gaughan JP, Samdani AF, Pahys JM, Betz RR, Cahill PJ. Serial casting for infantile idiopathic scoliosis: radiographic outcomes and factors associated with response to treatment. J Pediatr Orthop. 2017;37:311–6.CrossRef Iorio J, Orlando G, Diefenbach C, Gaughan JP, Samdani AF, Pahys JM, Betz RR, Cahill PJ. Serial casting for infantile idiopathic scoliosis: radiographic outcomes and factors associated with response to treatment. J Pediatr Orthop. 2017;37:311–6.CrossRef
19.
go back to reference Canavese F, Samba A, Dimeglio A, Mansour M, Rousset M. Serial elongation-derotation-flexion casting for children with early-onset scoliosis. World J Orthop. 2015;6:935–43.CrossRef Canavese F, Samba A, Dimeglio A, Mansour M, Rousset M. Serial elongation-derotation-flexion casting for children with early-onset scoliosis. World J Orthop. 2015;6:935–43.CrossRef
20.
go back to reference Abraham R, Sponseller PD. Focused molding using adhesive pads in Mehta casting for early-onset scoliosis. Spine Deform. 2014;2:454–9.CrossRef Abraham R, Sponseller PD. Focused molding using adhesive pads in Mehta casting for early-onset scoliosis. Spine Deform. 2014;2:454–9.CrossRef
21.
go back to reference Fletcher ND, McClung A, Rathjen KE, Denning JR, Browne R, Johnston CE 3rd. Serial casting as a delay tactic in the treatment of moderate-to-severe early-onset scoliosis. J Pediatr Orthop. 2012;32:664–71.CrossRef Fletcher ND, McClung A, Rathjen KE, Denning JR, Browne R, Johnston CE 3rd. Serial casting as a delay tactic in the treatment of moderate-to-severe early-onset scoliosis. J Pediatr Orthop. 2012;32:664–71.CrossRef
22.
go back to reference Zhang H, Sucato DJ, Nurenberg P, McClung A. Morphometric Analysis of vertebral growth using magnetic resonance imaging in the normal skeletally immature spine. Spine. 2018;43:133–40.CrossRef Zhang H, Sucato DJ, Nurenberg P, McClung A. Morphometric Analysis of vertebral growth using magnetic resonance imaging in the normal skeletally immature spine. Spine. 2018;43:133–40.CrossRef
Metadata
Title
Brace treatment can serve as a time-buying tactic for patients with congenital scoliosis
Authors
Yuwen Wang
Zongxian Feng
Zhichong Wu
Yong Qiu
Zezhang Zhu
Leilei Xu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1244-4

Other articles of this Issue 1/2019

Journal of Orthopaedic Surgery and Research 1/2019 Go to the issue