Significance of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients

Scoliosis

Naoya Tajima¹  Etsuo Chosa²  Hideaki Hamanaka²  Naoki Inomata²  Hiroshi Kuroki² 

[1] Department of Orthopaedic Surgery, Nozaki Higashi Hospital, Miyazaki, Japan;Department of Orthopaedic Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan

关键词: Osaka Medical College (OMC) brace;    Brace treatment;    Spinal flexibility;    Hanging total spine x-ray;    Idiopathic scoliosis;   

Others  :  791612
DOI  :  10.1186/1748-7161-7-8

 received in 2011-12-28, accepted in 2012-03-27,  发布年份 2012

【 摘 要 】

Background

Although most idiopathic scoliosis patients subject to conservative treatment in daily clinical practice, there have been no ideal methods to evaluate the spinal flexibility for the patients who are scheduled the brace treatment. The purpose of this study was to investigate the value of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients.

Methods

One hundred seventy-six consecutive patients with idiopathic scoliosis who were newly prescribed the Osaka Medical College (OMC) brace were studied. The study included 14 boys and 162 girls with a mean age of 13 years and 1 month. The type of curves consisted of 62 thoracic, 23 thoracolumbar, 22 lumbar, 42 double major, 14 double thoracic, and 13 triple curve pattern. We compared the Cobb angles on initial brace wearing (BA) and in hanging position (HA). Of those, 108 patients who had main thoracic curves were selected and evaluated the corrective ability of OMC brace. These subjects were divided into three groups according to the relation between BA and HA (BA < HA group, BA = HA group, and BA > HA group), and then, maturity was compared among them.

Results

The average Cobb angle in upright position (UA) of all cases was 31.0 ± 7.8°. The average BA and HA of all cases were 20.3 ± 9.5° and 21.1 ± 8.4°, respectively. The average chronological age was lowest in BA < HA group. And also, maturity in BA < HA group was the lowest among each of them. The rate of BA < HA cases were decreased as the Risser stage of the patients were progressed.

Conclusions

The use of hanging total spine x-ray served as a useful tool to estimate the degree of correction possible curve within the OMC brace for main thoracic curve in idiopathic scoliosis. Maturity had some influence on the correlation between HA and BA. Namely, in immature patients, HA tended to be larger than BA. In contrast, in mature patients, HA had a tendency to be smaller than BA. With consideration for spinal flexibility based on maturity, in mature patients, larger BA than HA may be allowed. However, in immature patients, smaller BA than HA should be aimed.

【 授权许可】

   
2012 Kuroki et al; licensee BioMed Central Ltd.

【 图 表 】

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