Indications for conservative management of scoliosis (guidelines)

Weiss, Hans‐Rudolf; Négrini, Stefano; Rigo, Manuel; Kotwicki, Tomasz; Hawes, Martha C.; Grivas, Theodoros B; Maruyama, Toru; Landauer, Franz

doi:10.1186/1748-7161-1-5

Cited by 154 publications

(138 citation statements)

References 32 publications

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“…If the curve is between 25° and 40° in a skeletally immature patient with a Risser Grade 0-1, most would agree that bracing is indicated. 32,36,43,46,62 While the goal of bracing is to deter further progression of the curve, bracing will not result in curve regression. Two types of braces are used for treating AIS: a thoracolumbosacral orthosis (TLSO) and a cervicothoracolumbosacral orthosis (CTLSO).…”

Section: Nonsurgical Treatmentmentioning

confidence: 99%

Evaluation and management of adolescent idiopathic scoliosis: a review

Jada

Mackel

Hwang

et al. 2017

Neurosurgical Focus

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Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options.Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS.Patients with AIS can be managed very well with a combination of conservative and surgical options. Outcomes for these children are excellent with sustained longer-term results.

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Section: Nonsurgical Treatmentmentioning

confidence: 99%

Evaluation and management of adolescent idiopathic scoliosis: a review

Jada

Mackel

Hwang

et al. 2017

Neurosurgical Focus

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“…Therefore, it is no surprise to find that respiratory impairment is considered the most serious consequence of severe scoliosis as patients frequently develop a progressive reduction in their lung volumes (restrictive ventilatory pattern), inspiratory muscle weakness and reduced exercise capacity, and can even suffer a sudden death episode [2][3][4][5][6][8][9][10]. Classical therapy of adolescent idiopathic scoliosis (AIS) includes orthopaedic treatment, relative rest and/or rehabilitation and, in the most severe cases, surgery and/or ventilatory support [2,[11][12][13][14][15]. The causes of exercise limitation in this disorder have not been fully elucidated, but ventilatory restriction and subsequent cardiovascular deconditioning are the most commonly accepted [10,16].…”

mentioning

confidence: 99%

Muscle dysfunction and exercise limitation in adolescent idiopathic scoliosis

Martínez‐Llorens¹,

Ramírez²,

Colomina³

et al. 2009

European Respiratory Journal

100

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Adolescent idiopathic scoliosis (AIS) can lead to ventilatory restriction, respiratory muscle weakness and exercise limitation. However, both the causes and the extent of muscle dysfunction remain unclear. The aim of our study is to describe muscle weakness and its relationship to lung function and tolerance to exercise in AIS patients.Lung and muscle function, together with exercise capacity, were assessed in 60 patients with pronounced spinal deformity (.40u) and in 25 healthy volunteers.Patients with AIS had only mild to moderate abnormal ventilatory patterns, the most frequent of which were restrictive abnormalities. The function of respiratory and limb muscles and exercise capacity were below normal limits in AIS patients, and were significantly lower than in controls. Exercise capacity was found to correlate with the function of inspiratory, expiratory, upper limb and lower limb muscles which, in addition, were reciprocally interrelated. Multivariate analysis showed that lower limb muscle function is the main contributor to exercise intolerance. There appeared to be no connection between spinal deformity and lung function, muscle function or exercise capacity.We conclude that AIS patients show generalised muscle dysfunction which contributes to the reduction in their exercise capacity, even in the absence of severe ventilatory impairment.

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“…Physical therapy for scoliosis is not just general exercises but rather one of the cited methods designed to address the particular nuances of spinal deformity and application of such methods requires therapists and clinicians specifically trained and certified in those scoliosis specific conservative intervention methods [12,13].…”

Section: Spine Research Issn 2471-8173mentioning

confidence: 99%