Short-term outcome of double-shelled braces in neuromuscular scoliosis
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ORTHOPAEDIC SURGERY
Short‑term outcome of double‑shelled braces in neuromuscular scoliosis Natalia D. Vogel‑Tgetgel1 · Michèle Kläusler1,4 · Reinald Brunner1,2 · Carlo Camathias1,2,3 · Erich Rutz1,2,5 Received: 23 March 2020 / Accepted: 9 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Scoliosis in patients with neuromuscular disease is a common issue and leads to secondary impairment. It is thus important to help such patients to regain and retain best possible stability to improve their quality of life. One option is the double-shelled brace (DSB). The aim of this study was to provide information on the degree of correction when using a DSB on patients with neuromuscular scoliosis. Methods We included patients with neuromuscular scoliosis treated with double-shelled braces in this retrospective study. Radiographs of the full spine were taken with and without the DSB, the Cobb angles were measured and compared. The correction was expressed in percent of the lumbar and thoracic Cobb angles. In addition, compounding factors such as age, sex, type of the curves, and movement disorder were included. Results We analyzed data from 84 patients with scoliosis with different neuromuscular disorders. The mean age was 12.3 years (± 5.9). In the lumbar spine we detected an improvement of 27.5% (SD ± 32.9), in the thoracic spine 25.3% (SD ± 38.0). Interpretation Short-term corrections with a double-shelled brace in neuromuscular scoliosis present an average improvement of one fourth of the lumbar and thoracic Cobb angles and, independent of age, sex, movement disorder, shape or type of the curve. Only spasticity has an influence on the lumbar scoliosis outcome. Keywords Neuromuscular scoliosis · Spinal bracing · Double-shelled braces · Conservative treatment scoliosis · Nonoperative treatment Abbreviations DSB Double-shelled brace CP Cerebral palsy NMS Neuromuscular scoliosis MMC Myelomeningocele SMA Spinal muscle atrophy GMFCS Gross Motor Function Classification System AP Anterior–posterior * Natalia D. Vogel‑Tgetgel [email protected] 1
Department of Orthopedic, University Children’s Hospital UKBB, Spitalstrasse 33, 4056 Basel, Switzerland
2
University of Basel, Basel, Switzerland
3
Praxis Zeppelin, St. Gallen, Switzerland
4
Orthopedic Department, Hospital of Solothurn, Solothurn, Switzerland
5
Murdoch Children’s Research Institute, MCRI, The Royal Children’s Hospital, Parkville, VIC, Australia
Introduction Scoliosis is a well-known issue in children and adolescents with neuromuscular disorders, cerebral palsy (CP) being the most common. The incidence of neuromuscular scoliosis (NMS) differs greatly, depending on the underlying disease and the body involvement. The list of diagnoses include CP, Duchenne muscular dystrophy, myelomeningocele (MMC), spinal muscle atrophy (SMA), Friedreich ataxia and spinal cord injuries [1–3]. Patients with NMS are for the most part CP patients [1, 4]. The incidence in this population is about 20–25%. Sco
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