Progression in Untreated Idiopathic Scoliosis After end of Growth

Bjerkreim, Ingjald; Hassan, Ibrahim

doi:10.3109/17453678208992845

Cited by 32 publications

(10 citation statements)

References 5 publications

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“…When attempting to quantify the progression risk for patients that are Risser 0 AND above 30˚to 40˚AND who are noncompliant, it is important to consider that most of these numbers are based on 50˚success cut off, whereas there is a significant concern that many of the 45˚patients will actually progress to 50˚in a short period of time [8,38,39]. If 45˚was used as a success cut off, the numbers may have been significantly higher.…”

Section: Discussionmentioning

confidence: 99%

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Hawary

Zaaroor-Regev²,

Floman

et al. 2019

The Spine Journal

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Brace treatment is the most common nonoperative treatment for the prevention of curve progression in adolescent idiopathic scoliosis. The success reported in level 1 and 2 clinical trials is approximately 75%. The aim of this review was to identify the main risk factors that significantly reduce success rate of brace treatment.A literature search using the MEDLINE and Embase databases was conducted. Studies were included if they identified specific risk factor(s) for curve progression. Studies that looked at nighttime braces, superiority of one type of brace over another, the effect of physical therapy on brace performance, cadaver or nonhuman studies were excluded. A total of 1,022 articles were identified of which 25 met all of the inclusion criteria. Seven risk factors were identified: Poor brace compliance (eight studies), lack of skeletal maturity (six studies), Cobb angle over a certain threshold (six studies), poor in-brace correction (three studies), vertebral rotation (four studies), osteopenia (two studies), and thoracic curve type (two studies). Three risk factors were highly repeated in the literature which identified specific subgroups of patients who have a much higher risk to fail brace treatment and to progress to fusion. This data demonstrates that 60% to 70% of the patients referred to bracing are Risser 0 and 30% to 70% of this group will not wear the brace enough to ensure treatment efficacy. Furthermore, Risser 0 patients who reach the accelerated growth phase with a curve ≥40˚are at 70% to 100% risk of curve progression to the fusion surgical threshold despite proper brace wear. Skeletally immature patients with relatively large magnitude scoliosis who are noncompliant FDA device/drug status: Not applicable.

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Section: Discussionmentioning

confidence: 99%

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Hawary

Zaaroor-Regev²,

Floman

et al. 2019

The Spine Journal

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“…We therefore conclude that early treatment of unilateral cross bite is advisable since it does affect negatively the vertebral column. After the adolescent growth spurt, conservative correction of spinal postural disorders seems to be more difficult [25,26]. …”

Section: Discussionmentioning

confidence: 99%

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

Lippold¹,

Moiseenko²,

Drerup

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe aim of this randomized clinical trial was to assess the effect of early orthodontic treatment for unilateral posterior cross bite in the late deciduous and early mixed dentition using orthopedic parameters.MethodsEarly orthodontic treatment was performed by initial maxillary expansion and subsequent activator therapy (Münster treatment concept). The patient sample was initially comprised of 80 patients with unilateral posterior cross bite (mean age 7.3 years, SD 2.1 years). After randomization, 77 children attended the initial examination appointment (therapy = 37, control = 40); 31 children in the therapy group and 35 children in the control group were monitored at the follow-up examination (T2). The mean interval between T1 and T2 was 1.1 years (SD 0.2 years). Rasterstereography was used for back shape analysis at T1 and T2. Using the profile, the kyphotic and lordotic angle, the surface rotation, the lateral deviation, pelvic tilt and pelvic torsion, statistical differences at T1 and T2 between the therapy and control groups were calculated (t-test).Our working hypothesis was, that early orthodontic treatment can induce negative therapeutic changes in body posture through thoracic and lumbar position changes in preadolescents with uniltaral cross bite.ResultsNo clinically relevant differences between the control and the therapy groups at T1 and T2 were found for the parameters of kyphotic and lordotic angle, the surface rotation, lateral deviation, pelvic tilt, and pelvic torsion.ConclusionsOur working hypothesis was tested to be not correct (within the limitations of this study). This randomized clinical trial demonstrates that in a juvenile population with unilateral posterior cross bite the selected early orthodontic treatment protocol does not affect negatively the postural parameters.Trial registrationDRKS00003497 on DRKS

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“…The mechanical imbalance inherent in scoliosis, irrespective of its cause, results in asymmetric loading which constitutes a 'vicious cycle' with an inevitable tendency to worsen with time [61][62][63]. In fact, most cases of scoliosis do continue to progress throughout the life of the patient [16,40,42,45,[64][65][66]. Symptoms that occur in association with scoliosis include pain [40,[45][46][47][67][68][69][70][71][72][73][74][75][76][77][78] and psychological distress [14,16,24,49,[79][80][81][82][83][84][85][86][87].…”

Section: Historical Perspective On Scoliosis Treatment In Western Medmentioning

confidence: 99%

“…In fact, the dogma that exercises are without potential benefit is so entrenched that possible effects of such therapies in patient outcomes are simply ignored. Thus, 'natural history' surveys describing outcome in purportedly 'untreated' populations generally have included patients who used exercises or received therapeutic treatment by professionals other than surgeons [16,[40][41][42][43][44][45][46][47][48][49][50]. These patients were presumed to exhibit the same disease course as an untreated patient and were included within the 'natural history' populations.…”

mentioning

confidence: 99%

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

Hawes¹

2003

Pediatric Rehabilitation

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The loss of flexibility in a spinal curvature defines it as a structural spinal deformity; a curvature sufficiently mobile to resolve with a change in posture is a non-structural or 'functional' scoliosis which is within the normal limits of movement for a human spine. It, therefore, seems logical that exercise-based therapies designed to improve and/or maintain flexibility and range of motion of the spine and thorax would be useful in the treatment of scoliosis. Recognition of the importance of maintaining flexibility of the thoracic spinal column to avoid scoliosis-associated pulmonary dysfunction made the use of exercise-based therapies a topic of clinical interest in ancient Greece. In recent years, successful prevention of polio epidemics has resulted in a stable change in patient populations such that most individuals diagnosed with scoliosis do not suffer from irreversible central nervous system compromise. As a result, realistic opportunities to examine the role of exercise in treatment of scoliosis are available for the first time in history. A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults.

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Progression in Untreated Idiopathic Scoliosis After end of Growth

Cited by 32 publications

References 5 publications

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

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