Dabaghi RA, Cadena PAL

Language: Spanish
References: 9
Page: 4-8
PDF size: 175.14 Kb.

ABSTRACT

Introduction: Congenital scoliosis is the result of anomalous development of the vertebrae, secondary to failure in the formation or segmentation of one or more vertebral segments. It has been demonstrated that the corrective casts, help in the correction of the curve in idiopathic scoliosis. However, the use of corrective casts in patients with congenital scoliosis has not been fully studied. Objective: Evaluation of the results of the use of corrective casts in patients with congenital scoliosis and its usefulness in the future. Material and methods: A retrospective study of all the patients with diagnosis of congenital scoliosis treated with corrective casts in the Shriners Hospital for children, Mexico City. With a follow-up of at least one year. The radiographic measurements were the angle of the curve (Cobb angle) pre and post cast application and thoracic height (T1 to T12). Results: A total of 15 patients, two women (13%) and 13 men (87%).The mean age at the first cast was 4.2 years of age, with a range of age of 2.4 years to 7.3 years. We have an equal sample of type of deformity with a diagnosis of 33.3% for deformity of segmentation, 33.3% of formation and 33.3% mixed deformity. The average of number of casts 3.7, with a standard deviation of 2.1. The average of using the cast was 16.6 months with a standard deviation of 11.2, with a minimum of five months and a maximum of 47 months. Also the first Cobb angle comparing with the last measurement for each of the subjects, without a statistically significant differences (Cobb1 Mean 63.5, Last Cobb Mean 62.3, p = 0.754). Finally, the average height in the first measurement was 141.60 (standard deviation of 35.8, Minimum 100, Maximum 141.6), while in the final was 159.07 (SD 47.8, Min 111, Max 311). Statistically significant differences were found between both measurements (p = 0.016). Conclusions: The type of deformity is not related to the progression of the curve in the treatment of corrective casts. Understand that it is possible to increase the thoracic height. This treatment is a strategy to delay the surgical intervention during the first year of its application. However, after 16 months the curves tend to progress. That's why the use of corrective casts in congenital scoliosis did not prove to be an effective long-term treatment to stop the progression of the curves.

REFERENCES

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EVIDENCE LEVEL

IV