PDF(Pubmed)
Abstract：
Serial casting as one of the applications to treat early-onset scoliosis has been reported efficiently to improve deformity, but no report has focused on the efficacy of braces in the treatment of congenital early-onset scoliosis and comparison with progressive idiopathic early-onset scoliosis. Patients with progressive EOS treated with braces in our institution with a minimum of 4 years follow-up were reviewed. Two groups according to the etiological diagnosis were analyzed and compared: the congenital scoliosis (CS) group and idiopathic scoliosis (IS) group. The success cases and the failure cases were also compared. 27 patients with an average main Cobb angle of 38.19° (20-55) underwent initial bracing at an average age of 55.7 months (24-108), the average follow-up time was 76.19 months (49-117). In IS group the main Cobb angle was corrected to 18.69 ± 12.06° (48.61%) following the first bracing; the final Cobb angle was 23.08 ± 22.15°(38.76%) after brace removal. In CS group the main Cobb angle was corrected to 33.93 ± 10.31°(17.1%) following the first bracing and 37.93 ± 14.74°(3.53%) after brace removal. Both coronal chest width and T1-T12 height increased dramatically from pre-bracing to the last follow-up. Patients diagnosed as IS tended to have a better result in main Cobb angle correction than that of CS (P = 0.049). By the time of last follow-up, 8 patients had undergone surgery, and the operation time was postponed by 68.88 ± 26.43 months. For patients with progressive early-onset scoliosis, bracing is an efficient nonsurgical alternative to casting, and some of them can be cured; if not, eventual surgical intervention can be delayed for a period of time without restrictions on the thoracic cavity.
摘要：
连续铸造作为治疗早发性脊柱侧凸的应用之一，已被报道有效地改善畸形，但目前还没有关于矫正器治疗先天性早发性脊柱侧凸的疗效以及与进行性特发性早发性脊柱侧凸的比较的报道。对在我们机构接受支架治疗的进行性EOS患者进行了至少4年的随访。根据病因诊断对两组进行分析比较:先天性脊柱侧凸(CS)组和特发性脊柱侧凸(IS)组。比较了成功案例和失败案例。平均主Cobb角为38.19°（20-55）的27例患者在平均年龄为55.7个月（24-108）时接受了初始支撑，平均随访时间为76.19个月(49～117个月)。在IS组中，第一次支撑后，主要Cobb角校正为18.69±12.06°（48.61％）；移除支架后，最终Cobb角为23.08±22.15°（38.76％）。在CS组中，第一次支撑后的主要Cobb角校正为33.93±10.31°（17.1％），移除支撑后的主要Cobb角校正为37.93±14.74°（3.53％）。从支撑前到最后一次随访，冠状胸宽和T1-T12高度均显着增加。诊断为IS的患者在主Cobb角校正方面的效果优于CS（P=0.049）。到最后一次随访时，8名患者接受了手术，手术时间推迟68.88±26.43个月。对于进行性早发性脊柱侧凸患者，支撑是铸造的一种有效的非手术替代方法，其中一些可以治愈；如果没有，最终的手术干预可以延迟一段时间，而不限制胸腔。
