Nonsurgical Management of Early-onset Scoliosis

Thorsness, Robert; Faust, John R; Behrend, Caleb

doi:10.5435/jaaos-d-14-00019

Cited by 37 publications

(27 citation statements)

References 37 publications

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“…5 The most common causes of EOS are idiopathic, congenital, neuromuscular, or syndromic. 6 The deformity may inhibit the development and function of the heart and lungs, representing 2 of the most severe consequences of EOS. [7][8][9] According to the etiology and evolution of the disease, motor function impairment of the patient is observed, with a consequent decrease in recreational activities and routine activities, such as brushing and bathing, and a compromise of cardiopulmonary, intestinal, and bladder function, together with intense pain.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Brazilian Portuguese Version of the 24-Item Early-Onset Scoliosis Questionnaire

Mendonça¹,

Bergamascki²,

Silva³

et al. 2020

Global Spine Journal

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Study Design: Multicenter prospective study. Objectives: To validate the Early-Onset Scoliosis 24 Questionnaire (EOSQ-24) questionnaire for the Brazilian Portuguese language, a widely used tool for assessing the impact of different treatments and interventions in EOS patients. Methods: The EOSQ-24 questionnaire was cross-culturally adapted following guidelines already published. After language adjustments by a group of experts, the final version of the Brazilian Portuguese EOSQ-24 was applied to a group of 76 patients (35 male and 41 female). Internal consistency was evaluated using the Cronbach α coefficient and item-total correlations. Continuous variables were recorded as median values and interquartile ranges and categorical variables as percentages. Results: In the study group, 76 patients were evaluated. The total EOSQ-24 Cronbach α coefficient was 0.883, indicating excellent reliability. The internal consistency of EOSQ-24 was assessed in 3 domains: patient quality of Life, parental burden, and satisfaction (Cronbach α: 0.816-0.934). The range across all subdomains was 0.473 to 0.934. Floor effects for the 24 items were between 1.3% and 43.4% and ceiling effects, between 3.9% and 42.1%. Conclusions: The Brazilian Portuguese adaptation of the EOSQ-24 shows excellent reliability and can be a valid tool for psychometric assessment of children with EOS.

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Section: Introductionmentioning

confidence: 99%

Validation of the Brazilian Portuguese Version of the 24-Item Early-Onset Scoliosis Questionnaire

Mendonça¹,

Bergamascki²,

Silva³

et al. 2020

Global Spine Journal

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“…Spontaneous resolution of IS has been observed in cases with the “benign” form [19]. In contrast, the natural history of non-idiopathic early onset scoliosis is usually progressive.…”

Section: Discussionmentioning

confidence: 99%

Serial casting in early onset scoliosis: syndromic scoliosis is no contraindication

Ballhause

Moritz

Hättich

et al. 2019

BMC Musculoskelet Disord

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BackgroundSerial casting is a treatment for early onset scoliosis (EOS) in young children to achieve curve correction before bracing or to postpone initial surgical treatment until the patient is older. Good results have been reported for patients with idiopathic early onset scoliosis (IS). However, there are few reports of results in non-idiopathic cases, and the benefits of non-surgical methods in the syndromic-associated early onset scoliosis subgroup are unknown.MethodsRetrospective single-institution study of patient charts and X-rays of all cases of sustained serial casting for EOS.Staged correction was obtained by applying three consecutive casts under general anaesthesia. These were changed every 4 weeks, followed by the implementation of a custom-made full-time Chêneau brace. Correction was measured by Cobb angle (CA) and rib-vertebra angle difference (RVAD) on whole spine anterior-posterior radiographs. Statistical analysis was performed via ANOVA.ResultsThe study group consisted of 6 patiens with IS and 10 with non-idiopathic scoliosis (NIS) – exclusively syndromic-associated. The mean age at onset of treatment was 35 months (±15). The mean follow up was 21 months (±15). In IS patients average CA/RVAD before treatment was 46°(±8)/20°(±12). In NIS patients average CA/RVAD before treatment was 55°(±15)/24°(±14). After application of the third cast, the CA/RVAD was reduced to 20°(±11)/11°(±10) in IS patients. Whereas in NIS patients average CA/RVAD after the thrid cast was 28°(±12)/18°(±13). At latest follow-up the CA/RVAD was 16°(±7)/9°(±8) in IS patients and 31°(±11)/17° (±15) in NIS patients.ConclusionSyndromic etiology is not a contraindication for serial casting in EOS. Our results show a curve correction, measured in CA, of 65% in IS patients and 44% in NIS patients. Significant reduction in the morphologic deformity, measured in RVAD, was achieved in the IS cohort, but not in the NIS cohort. In all cases surgical treatment could be delayed.

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“…We found that 56% of orthopaedists take the first in-cast radiograph in the supine position, while the rest take it with the patient standing and awake. The distinction is important because major curve angles are smaller in supine than standing radiographs, 9 preventing accurate comparison between patients in different positions. However, it is important to consider the age and diagnosis of the patient population, which cause natural variations in ambulatory ability.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports of cast treatment for long congenital curves with multiple anomalous vertebrae found thoracic growth rate was slower than normal, 11 but that T1-T12 height increased significantly over treatment. 12 Neuromuscular patients often have respiratory and gastrointestinal co-morbidities, 9 but their cast treatment outcomes have been described. 6 , 7 , 10 , 13 - 15 In general, they are found to attain less major curve angle correction 16 and greater correction loss after cast removal than idiopathic patients.…”

Section: Discussionmentioning

confidence: 99%

Survey to describe variability in early onset scoliosis cast practices

Grzywna

McClung

Sturm

et al. 2018

Journal of Children's Orthopaedics

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PurposeTo investigate paediatric orthopaedists’ cast practices for early onset scoliosis regarding patient selection, cast application, radiographic evaluation, treatment cessation and adjunctive bracing.MethodsA casting survey was distributed to all paediatric orthopaedists in Children’s Spine and Growing Spine Study Groups (n = 92). Questions included physician and patient characteristics, technique, treatment, outcomes, radiographic measurements and comparison to other treatments. A total of 55 orthopaedists (60%) responded, and descriptive statistics were calculated on the subset who cast (n = 45).ResultsA majority of respondents use cast treatment for idiopathic and syndromic scoliosis patients, but not for neuromuscular or congenital scoliosis patients. Major curve angle ranked most important in orthopaedists’ decision to commence cast treatment, in comparison with rib-vertebra angle difference or clinical observations. The major curve angle threshold to initiate casting was a median of 30° (20° to 70°), and the minimum patient age was median ten months (3 to 24). First in-cast and out-of-cast radiographs are taken standing, supine, awake, under anesthesia and/or in traction. In all, 58% consistently cast over or under the arm, while 44% vary position by patient. Respondents were divided about the use of a brace after cast treatment: 22% do not prescribe a brace, 31% always do and 36% do in some patients.ConclusionsFuture multicentre research studies must standardize radiographic practices and consider age and major curve angle at cast initiation and termination, scoliosis aetiology, shoulder position and treatment duration. Practices need to be aligned or compared in these areas in order to distinguish what makes for the best cast treatment possible.Level of EvidenceV, Expert opinion

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Nonsurgical Management of Early-onset Scoliosis

Cited by 37 publications

References 37 publications

Validation of the Brazilian Portuguese Version of the 24-Item Early-Onset Scoliosis Questionnaire

Validation of the Brazilian Portuguese Version of the 24-Item Early-Onset Scoliosis Questionnaire

Serial casting in early onset scoliosis: syndromic scoliosis is no contraindication

Survey to describe variability in early onset scoliosis cast practices

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