SpineCor treatment for Juvenile Idiopathic Scoliosis: SOSORT award 2010 winner

Abstract

IntroductionJuvenile idiopathic scoliosis is a condition used to describe patients who are least 4 years of age but younger than 10 when the deformity is first identified. In these patients, the condition is usually progressive and those that are diagnosed at five years or younger have a high chance of progression to a large curve, with additional pulmonary and cardiac complications. The main form of conservative treatment for juvenile scoliosis is the use of a bracing system. This prospective interventional study was conducted to evaluate the effectiveness of the Dynamic SpineCor orthosis for juvenile idiopathic scoliosis as well as to evaluate the stability of the spine after the weaning point.Material and MethodsFor this study, 150 juvenile patients were treated by the SpineCor orthosis between 1993 and 2009. Of these, 67 patients had a definite outcome and 83 are still actively being treated. To determine the effectiveness of the brace the OUTCOME criteria recommended by the SRS was used.ResultsThe results from our study showed that of the 67 patients with a definite outcome, 32.9% corrected their Cobb angle by at least 5° and 10.5% had a stabilization of their Cobb angle. Within the patients with a definite outcome, 37.3% of patients where recommended for surgery before authorized end of treatment. For this group of patients, surgery was postponed. Looking at the stability of the curves 2 years after the end of the treatment, we found 12.5% of the patients continued their correction without the brace being used and 71.4% remained stable.DiscussionFrom our study we can clearly see that the effectiveness of the SpineCor orthosis in obtaining and maintaining the neuromuscular integration of the corrective movement can be achieved effectively for juvenile patients. Over 75% of all patients that finished the treatment had remained stable with a few continuing to correct their Cobb angle after the use of the SpineCor orthosis was discontinued.ConclusionOur conclusion from this study is that the SpineCor orthosis is a very effective method of treatment of juvenile idiopathic scoliosis. The results obtained also indicate that treatment outcomes are better with early bracing. Most encouraging perhaps is the fact that the positive outcome appears to be maintained in the long term, and that surgery can be avoided or at least postponed.

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

“…• Soft Bracing (SB) : it includes mainly the SpineCor brace [ 102 , 103 ], but also other similar designs [ 104 , 105 ]…”

Epidemiology of adolescent idiopathic scoliosis

“…Juvenile scoliosis: Juvenile scoliosis develops at the age of 4-10 years and comprises 10-15 % of all idiopathic scoliosis in children [14], untreated curves may cause serious cardiopulmonary complications, and curves of 30°and more tend to progress, 95 % of these patients need a surgical procedure [14].…”

Radiological evaluation of treatment with SpineCor brace in children with idiopathic spinal scoliosis

“…In a study by Coillard et al, a 2-year follow-up after treatment completion demonstrated curvature stabilisation in 95.7% of patients. Moreover, 10% of the patients in that group demonstrated further spontaneous correction of scoliosis [17].…”

“…w 2-let nim okre sie ob serwa cji od mo men tu za koń cze nia le cze nia u 95,7% cho rych wy ka za no sta bi li za cję skrzy wie nia. Po nad to u 10% cho rych w tej gru pie wy ka za no dal szą sponta nicz ną ko rek cję skrzy wie nia [17].…”