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Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O'Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagrasa M, Weiss HR, Zaina F. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. SCOLIOSIS 2012; 7:3. [PMID: 22264320 PMCID: PMC3292965 DOI: 10.1186/1748-7161-7-3] [Citation(s) in RCA: 251] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 01/20/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). METHODS All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. RESULTS The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. CONCLUSION These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.
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Affiliation(s)
- Stefano Negrini
- Physical and Rehabilitation Medicine, University of Brescia, Italy
- Don Gnocchi Foundation, Milan, Italy
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Angelo G Aulisa
- Orthopaedics and Traumatology Division, Bambino Gesù Children's Hospital, Institute of Scientific Research, Piazza San Onofrio 4, 00165, Rome, Italy
| | - Lorenzo Aulisa
- Department of Orthopaedics, Catholic University of the Sacred Heart, University Hospital 'Agostino Gemelli', L.go F. Vito, 1-00168 Rome, Italy
| | - Alin B Circo
- Sainte Justine Hospital, University of Montreal, Canada
| | | | - Jacek Durmala
- Department of Rehabilitation, Medical University of Silesia and University Hospital, Katowice, Poland
| | - Theodoros B Grivas
- Department of Trauma and Orthopaedics, "Tzanio" General Hospital, Tzani and Afendouli 1 st, Piraeus 18536, Greece
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, 60064, USA
| | - Tomasz Kotwicki
- Spine Disorders Unit, Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland
| | - Toru Maruyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Japan
| | - Silvia Minozzi
- Cochrane Review Group on Drugs and Alcohol. Department of Epidemiology. Lazio Region. Via di Santa Costanza, 53. 00198 Rome. Italy
| | | | - Dimitris Papadopoulos
- Spondylos Laser Spine Lab, Orthopaedic Facility and Rehabilitation Center, 74, Messogion Ave, 115 27, Athens, Greece
| | - Manuel Rigo
- Institut Elena Salvá. Vía Augusta 185. 08021 Barcelona, Spain
| | | | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | | | | | - Hans-Rudolf Weiss
- Gesundheitsforum Nahetal. Alzeyer Str. 23. D-55457 Gensingen, Germany
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
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Haje SA, Haje DDP, Martins GEV, Ferrer MG. The spine lateral bending and the dynamic chest compression principles for concomitant orthotic treatment of scoliosis and pectus deformities. COLUNA/COLUMNA 2011. [DOI: 10.1590/s1808-18512011000400009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE:To investigate a concomitant orthotic treatment for coexisting scoliosis and pectus deformities. No detailed study on such concomitancy was found in literature. METHODS: A spine bending brace for use day and night, and dynamic chest compressor orthoses for use four hours a day, along with one hour of exercises, were prescribed. From 638 adolescents, 25 met the inclusion criteria for a retrospective study. Two groups of patients were identified: A (15 compliant patients) and B (10 non-compliant patients). The mean follow-up was 27 months for group A and 21 months for group B. Pre and post- treatment clinical signs of scoliosis and pectus were photographically compared. The scoliosis had radiologic evaluation by Cobb angle and Nash-Moe classification for vertebral rotation. RESULTS: For both conditions, scoliosis and pectus deformities, the outcome was significantly better in the compliant group (p<0.001 for both). One highly compliant adolescent with a 52º scoliosis and pectus carinatum, showed a surprising improvement to 27º after 40 months of treatment, when chest braces were interrupted and the weaning from the spine brace has started. A 34º scoliosis was maintained after 60 months of follow-up, with vertebral rotation improvement. CONCLUSION: The concomitant orthotic treatment yielded preliminary positive results for compliant patients, warranting investigation continuity.
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