This is a thought provoking post that is based on a scientific research paper.
Predicting which cases are likely to progress until surgeons would recommend surgery (usually around 40 degrees) should be very helpful for everybody involved. This should be especially helpful for parents that are dealing with the watch and wait approach utilized by their health care provider.
The wait and see, is unfortunately the standard approach in curves below 20 degrees as there is no method used today to predict which cases will progress and which will not.
There may be a way to predict which cases will progress through their time in Boston braces and end up with surgery. I read a research paper written in 1992 called Idiopathic scoliosis: prognostic value of the profile and I posted some insights from it in my blog post will my child need Scoliosis surgery.
The paper implies that there may be a way of looking at the sagittal profile of the thoracic spine that could help to predict which cases might end up in surgery due to progression of the curve.
In the research by Castelein and Veraart, adolescent girls with idiopathic scoliosis that eventually required treatment in a Boston brace were reviewed. Their cases were studied from an early stage, before they had their first period (pre-menarche) and when their Cobb angle was still below 20° (degrees). The girls were followed all the way through to the time that they were either weaned (Group 1) of their Boston brace or ended up in surgery (Group 2) due to progression above 40 degree Cobb Angle.
They found that girls in Group 2 had more backward tilting vertebrae in the upper thoracic area compared to the girls that did not progress until surgery was recommended.
Is the sagittal profile ever mentioned during your discussion with the surgeon?
Predicting which cases are likely to progress until surgeons would recommend surgery (usually around 40 degrees) should be very helpful for everybody involved. This should be especially helpful for parents that are dealing with the watch and wait approach utilized by their health care provider.
The wait and see, is unfortunately the standard approach in curves below 20 degrees as there is no method used today to predict which cases will progress and which will not.
There may be a way to predict which cases will progress through their time in Boston braces and end up with surgery. I read a research paper written in 1992 called Idiopathic scoliosis: prognostic value of the profile and I posted some insights from it in my blog post will my child need Scoliosis surgery.
The paper implies that there may be a way of looking at the sagittal profile of the thoracic spine that could help to predict which cases might end up in surgery due to progression of the curve.
In the research by Castelein and Veraart, adolescent girls with idiopathic scoliosis that eventually required treatment in a Boston brace were reviewed. Their cases were studied from an early stage, before they had their first period (pre-menarche) and when their Cobb angle was still below 20° (degrees). The girls were followed all the way through to the time that they were either weaned (Group 1) of their Boston brace or ended up in surgery (Group 2) due to progression above 40 degree Cobb Angle.
They found that girls in Group 2 had more backward tilting vertebrae in the upper thoracic area compared to the girls that did not progress until surgery was recommended.
Is the sagittal profile ever mentioned during your discussion with the surgeon?
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