Long-term Results of Conservative Therapy of Adolescent Idiopathic Scoliosis Using the Cheneau Brace

Abstract

Adolescent idiopathic scoliosis is a disease of the growing skeleton. The goal in therapy is to decelerate or to prevent progression of the spinal curve. As part of a retrospective study the patient group of the scoliosis surgery from 1995–2016 was analysed according to the inclusion criteria of the Scoliosis research Society (SRS). 159 of 643 of the patients fullfilled the specific criteria. The assessment of effectiveness was based on the progression of the angle of curvature. If it was ≤5° it was judged positively. The therapy in accordance to Cheneau is a full-time bracing orthosis. Data from 159 patients – 136 fem. (85.5%), 23 male (14.5%) was analysed. The average age at the beginning of treatment was 13.3±1.7 years. The average duration was 3.47±1.2 years. The average Cobb-angle before treatment was 28.39°±9.44°. At the completion is was 27.7°±12.34°. Stabilisation of scoliosis (≤5°) was achieved for 136 of the patients (85.5%). The final follow-up showed a progression of the Cobb angel>5° in 23 cases, of which 19 had to undergo secondary surgery. The length of therapy had a positive influence (p=0.057) on the result. Brace treatment constitutes an effective method of therapy at curvatures between 20–40°. Short duration of therapy correlates with a expressively increased risk towards progression (p=0.057). The Cheneau brace treatment constitutes an effective treatment at curvature angles between 20–40°. The risk of progression can be reduced by a timely and correct identification.

Zusammenfassung

Die idiopathische adoleszente Skoliose ist eine Erkrankung des wachsenden Skeletts. Das Therapieziel ist, die Progression der Wirbelsäulenkrümmung zu verhindern oder zu reduzieren. Im Rahmen einer retrospektiven Studie wurden Patienten der Skoliose-Sprechstunde von 1995 bis 2016 bzgl. der Korsetttherapie analysiert. Die Einschlusskriterien entsprachen den Vorgaben von Scoliosis Research Society (SRS) Die Effektivität der Therapie wurde anhand der Progression des Krümmungswinkels bewertet. Bei ≤ 5° wurde der Verlauf als positiv gewertet. Erfasst wurde die Krümmung zum Zeitpunkt der Erstdiagnostik und nach Abtrainieren des Korsetts mit einem follow-up von min. 2 Jahren. Die Therapie erfolgte mit Korsetten nach Cheneau als “full-time-bracing“. Es wurden die Daten von 159 Pat. - 136 weibl. (85,5%), 23 männl. (14,5%) ausgewertet. Das mittlere Alter zu Behandlungsbeginn lag bei 13,3±1,7 Jahren. Die mittlere Behandlungsdauer betrug 3,47±1,2 Jahren. Der mittlere Cobb Winkel vor der Behandlung betrug 28,39±9,44° und zum Abschluss der Behandlung 27,70±12,34°. Eine Stabilisierung der Krümmung wurde bei 136 Pat. (85,5%) erzielt. In 23 Fällen kam es zu einer Progression des Cobb-Winkels von> 5°, hiervon mussten sich 19 Pat. einer sekundären Operation unterziehen. Die Therapiedauer hatte einen relevanten Einfluss auf das Endergebnis (p=0,057). Die konservative Therapie der adoleszenten idiopathischen Skoliose mittels Cheneau Korsett stellt eine effektive Behandlungsstrategie bei Krümmungswinkeln zwischen 20–40° dar. Bei frühzeitiger korrekter Indikationsstellung und konsequenter Tragedauer lässt sich das Risiko der Progression der Skoliose deutlich verringern

Key words

long-term results of conservative therapy in scoliosis - Cheneau Brace - adolescent idiopathic scoliosis - long term results concerning SRS criteria

Schlüsselwörter

Langzeitergebnisse nach konservativer Skoliosetherapie - Idiopathische adoleszente Skoliose - Cheneau Korsett - Langzeit Ergebnisse unter Anwendung der SRS Einschlusskriterien

^* geteilte Erstautorenschaft

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