What radiological and physical parameters do you check in brace treatment of Idiopathic Scoliosis?-I think about check results brace treatment from start to end treatment.
Hi Krysztof.
The most important values during all time of treatment IS are Cobb angles.
Usually we compare separately X-rays without the brace each other and the same with the brace. As second parameters are rotation values mainly in the case with smaller correction of lumbar scoliotic curves (acc. to Cobb) or in cases which are especially complete observed.
In these cases we often used Othotimer for the observation of accurate time observation of brace wearing.
Likewise we have one problem with the treatment of our patients. Treatment chiefs are medical doctors only and they prescribe making X-ray pictures and hour regimes of bracing.
However we as orthotics-prosthetics can colect existed data when there are available.
Usually there is no much time to do more for patients and for research.
Best regards.
Pavel
P.S.: your last question in Research Gate about the software for brace modeling.
My question is very easy. For the best results there is the brain, talent and experience :-).
Yes, I agree with Pavel Cerny. I would add the following: gibbusometry, growth dynamics and Risser sign (important for discontinuing brace treatment) and checking the compliance (daily duration of brace bearing).
Bracing for Idiopathic Scoliosis (IS) is questionable and debatable subject. as there some studies recommend bracing and other shows no improvement by wearing brace.
Spine:
June 1993
A Statistical Comparison Between Natural History of Idiopathic Scoliosis and Brace Treatment in Skeletally Immature Adolescent Girls:
Situation for conservative bracing is still better. Look at the new SRS web-sites. There were modified in this September.
@Mahmoud Abdel-Ghany: Bracing is an important option for conservative treatment of idiopathic scoliosis. It is no more questionable or debatable (1993). Bracing reduces the necessity of surgery, if properly applied.
Mahmoud Abdel-Ghany: I reccomend you to look at some work of:
https://www.researchgate.net/profile/Josette_Bettany-Saltikov
https://www.researchgate.net/profile/Hans-Rudolf_Weiss
https://www.researchgate.net/profile/Stefano_Negrini
https://www.researchgate.net/profile/Fabio_Zaina
and their co-authors and another research group...
Conversely, frequent operations scoliosis becoming moot.
Pavel
@Pavel Cerny: Good results from conservative treatment of scoliosis make surgery to be applied less frequently. But I do believe that selected cases which show curve progressiveness, and tend to severe deformity should be discussed for surgery. Data that surgery is charged with many early and late complications do not make scoliosis surgery obsolete. An important issue is pros and contras to be frankly discussed with patients and their parents.
Proper application of braces in carefully selected patients of IS and implementation of an appropriate observation protocol (particularly those with Risser Sign 3 or less) while on brace is an effective treatment. Generally, however, braces are not effective for curves >40 degrees (Cobb's Angle), curves with Apical Vertebra Rotation >30 degrees or those with coronal decompensation.
Age of onset, severity and evolutivity are important moments in conservative treatment with brace of idiopathic scoliosis. In last years evidence has shown that bracing is the most effective non - surgical treatment; however, data are limited to adolescent idiopathic scoliosis.
We evaluated in idiopathic scoliosis radiography: Cobb degrees, vertebral rotation, vertebral wedging Risser and Heterometrias. In physical and functional examination: blood pressure, cardiorespiratory fitness, the stiffness of the spine, muscle condition, the humps, spirometry, cirtometria, cifolordoticos indexes, weight and other possible size musculoskeletal disorders .... in 1267 scoliosis cases treated with very good results, with FED System (www.sastre-escoliofed.com) , about 12%, must complement a corset Chêneau ....,
Thank"s all answers. My look is:
Radiographic
a) Cobb angle,
b) Risser Sign,
c) Rotation one for: (measured Raimondii, Perdriolle"a, or Nasha and Moe),
Physical examination:
a) vertical from C7
b) Scoliometer Trunk Rotation
c) ATSI/POTSI
d) Inclinometer
Natural history of curve progression is important. Progression Is defined by either a 5 or 10 0 change in curve magnitude, depending on the initial curve magnitude, on a standing radiograph (Lonstein JE), curve magnitude, and Risser sign and age, respectively, the larger the curve, the greater the probability the curve would progress even after skeletal maturity.
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