Brace Treatment in Neuromuscular Spine Deformity

Ólafsson, Yngvi; Saraste, Helena; Al-Dabbagh, Z.

doi:10.1097/01241398-199905000-00017

Cited by 57 publications

(35 citation statements)

References 10 publications

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“…9 In contrast, Letts and colleagues (1992) used a soft Boston orthosis in the management of neuromuscular scoliosis and noticed an improvement in the scoliosis with an average of 15 degrees, while the major advantage was a marked improvement in sitting stability in 80% of patients. 10 In another study, Olafsson et al (1999) observed that mean brace-induced Cobb-angle correction was 60% with <10° curve progression during the observation time and a good brace compliance. 11 However, Mullender et al (2008) did not recommend the use of orthosis to prevent the development or progression of scoliosis in myopathic patients.…”

Section: Discussionmentioning

confidence: 99%

“…10 In another study, Olafsson et al (1999) observed that mean brace-induced Cobb-angle correction was 60% with <10° curve progression during the observation time and a good brace compliance. 11 However, Mullender et al (2008) did not recommend the use of orthosis to prevent the development or progression of scoliosis in myopathic patients. They advocated the use of a sitting type orthosis for patients who reject surgery for improvement of sitting comfort.…”

Section: Discussionmentioning

confidence: 99%

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The effect of a spinal orthosis on posture and cardio-respiratory functions in progressive myopathic scoliosis

Mohanty

Tripathi

Lenka

et al. 2012

Prosthetics &Amp; Orthotics International

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Background: Historically, the orthotic treatment in progressive myopathic scoliosis has not been as effective as expected. The purpose of this study was to investigate the effect of a spinal orthosis on scoliotic curve correction, alignment of altered posture and cardio-respiratory functions. Case Description and Methods: An 11 year-old girl diagnosed with myopathy was fitted with a custom molded thoracolumbo-sacral orthosis to enhance the sitting ability. The cardio-respiratory tests were performed by a COSMED K4 b² metabolic analyzer. The anterior posterior radiographs were analyzed for measuring Cobb angle and Ferguson angle. A plumb line test was used to assess the postural improvements. Findings and Outcomes: No significant difference was observed for variables such as O 2 consumption level, PaO 2 , tidal volume, heart rate and energy expenditure/min. The improved posture was evident by shifting of the plumb line 18 mm towards the mid line with the use of orthosis. Very minor improvements in both angles were observed with the use of the brace. Conclusion:The brace treatment cannot be expected to have a lasting corrective effect although it can be used as a sitting support and for maintaining posture Clinical relevanceThis case study provides an objective prescription of thoraco-lumbo-sacral orthosis as a sitting support and for improving posture in progressive myopathic scoliosis if suitably designed and properly fitted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of a spinal orthosis on posture and cardio-respiratory functions in progressive myopathic scoliosis

Mohanty

Tripathi

Lenka

et al. 2012

Prosthetics &Amp; Orthotics International

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“…HC are often afflicted with severe spinal deformities, which have poor outcomes with brace treatments 11,12) . In these cases, good treatment outcomes have been reported with scoliosis surgery using modern instruments 3,6,8,9) .…”

Section: Discussionmentioning

confidence: 99%

Scoliosis surgery for handicapped children

Nakamura

Inaba

Kato

et al. 2017

Spine Surg Relat Res

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Abstract:Introduction: This study aimed to assess treatment outcomes and caregivers' satisfaction regarding scoliosis surgery for handicapped children.Methods: Handicapped children are, by definition, noncommunicatory and/or nonambulatory. We recruited 26 handicapped children who were followed-up for >1 year after a scoliosis surgery. We recruited 40 patients with adolescent idiopathic scoliosis (AIS) who underwent a surgery during the same period as controls. We used a posterior approach in all the children. We determined preoperative body mass index (BMI), main Cobb angle, Cincinnati correction index (CCI), and fusion level; intraoperative time and blood loss per level; and postoperative complications. We also assessed caregivers' satisfaction with surgical treatments for these patients using the modified Bridwell's questionnaire.Results: We have described the results as handicapped children/AIS. Median preoperative BMI was 16.1/18.6 kg/m 2 . Preoperative and final Cobb angles were 94.2°/59.7°and 39.7°/17.0°, respectively and CCI was 2.0/1.7. The number of fusion levels was 14.6/9.0. The operative time and blood loss per level were 40.1/44.1 minutes and 264/138 ml, respectively. Postoperative complications in handicapped children were adynamic ileus in 8 cases, dysphagia in 5, pneumonia in 3, urinary tract infection in 2, and superior mesenteric artery syndrome (SMA), surgical site deep infection, infectious enteritis, agitation, and liver dysfunction in 1 each. However, in the AIS group, there was only 1 case of SMA. Median caregivers' satisfaction score on the 0-10 visual analog scale was 9. Caregivers for 19 of the 26 handicapped cases (73%) recommended surgical treatment to caregivers of other children with the same disease.Conclusions: Surgical treatment for neuromuscular and syndromic scoliosis was associated with a high rate of postoperative complications. However, the caregivers' satisfaction score after surgery was high.

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“…Evidence for the use of orthoses to prevent scoliotic curve progression is mixed. Some authors have suggested bracing may slow curve progression (20), especially in younger patients with curves less than 40 degrees (20,22). Other groups have reported less success (21,22) and suggest braces may be beneficial as an interim measure before definitive surgical correction.…”

Section: Non-surgical Managementmentioning

confidence: 99%

The management of scoliosis in children with cerebral palsy: a review

Cloake¹,

Gardner²

2016

J. Spine Surg.

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Children who suffer with cerebral palsy (CP) have a significant chance of developing scoliosis during their early years and adolescence. The behavior of this scoliosis is closely associated with the severity of the CP disability and unlike idiopathic scoliosis, it continues to progress beyond skeletal maturity. Conservative measures may slow the progression of the curve, however, surgery remains the only definitive management option. Advances in surgical technique over the last 50 years have provided methods to effectively treat the deformity while also reducing complication rates. The increased risk of surgical complications with these complex patients make decisions about treatment challenging, however with careful pre-operative optimization and post-operative care, surgery can offer a significant improvement in quality of life. This review discusses the development of scoliosis in CP patient, evaluates conservative and surgical treatment options and assesses post-operative outcome.

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Brace Treatment in Neuromuscular Spine Deformity

Cited by 57 publications

References 10 publications

The effect of a spinal orthosis on posture and cardio-respiratory functions in progressive myopathic scoliosis

The effect of a spinal orthosis on posture and cardio-respiratory functions in progressive myopathic scoliosis

Scoliosis surgery for handicapped children

The management of scoliosis in children with cerebral palsy: a review

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