BENIGN INFANTILE IDIOPATHIC SCOLIOSIS FACTORS OF POOR RESULTS AFTER CONSERVATIVE TREATMENT
Joseph W WEHBE1, Ghassan N MAALOUF1, Rita Maria A CHIDIAC1, Alexandre H NEHME1, Christian C MORIN2
1Orthopedics department, Saint George University Hospital, Beirut
2Chief Children’s Orthopedics Department, Calot Institute, Berck sur mer, France
Keywords: Idiopathic infantile scoliosis, Conservative treatment, Prognostic factors.
Abstract
Study Design: A retrospective study of 33 patients with infantile idiopathic scoliosis treated conservatively and evaluated at maturity is presented. Objectives: To determine the factors of poor results after conservative treatment in this type of scoliosis. Summary of background data: Some benign infantile idiopathic scoliosis can heal after conservative treatment while others are refractory to the same treatment.
Methods: With the same conservative treatment 19 curves had positive results while 14 others needed surgical correction and fusion. A comparison between the two groups leads to the following conclusions: 1. Recovery is not exclusive to newborn scoliosis. It must be sought in progressive scoliosis, at least for the most flexible ones, called progressive. 2. The curves’ reducibility during a first evaluation seems to be an important element of prognosis, as are the thoracic gibbosity, the Cobb angle and the presence of structural vertebral deformities. 3. Repeated bracing is the major element of conservative treatment. Its goal is to obtain a complete vertebral detorsion and a symmetrical thorax, crucial to a favorable long-term development. 4. The conservative treatment can be stopped well before maturity, provided the structural vertebral deformities have disappeared.