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Park, Nam, Ahn, Yoo, and Moon: Result of Traction Thoracolumbosacral Orthosis in Idiopathic Scoliosis
Original Article

Journal of Korean Spine Surg 2003;10(3):248-254.

Published online: 12 February 2003

DOI: https://doi.org/10.4184/jkss.2003.10.3.248

Result of Traction Thoracolumbosacral Orthosis in Idiopathic Scoliosis

Weon-Wook Park, M.D., Tae-Wook Nam, M.D., Seong-Jun Ahn, M.D.∗, Seong-Ho Yoo, M.D.∗, Hyong-Guen Moon§

Spine Center, Busan Centum Hospital, Dae-dong Hospital, Busan, Korea

∗Department of Orthopedic Surgery, Dae-dong Hospital, Busan, Korea

§MS Meditec, Masan, Korea

Address reprint requests to Weon-Wook Park, M.D. Department of Orthopaedic Surgery, Spine center, Busan centum Hospital 1077-1, Kwangan-3dong, Suyoung-gu, Pusan 613-812, Korea Tel: 82-51-750-5000, Fax: 82-51-751-1095, E-mail: pww@scoliosis.co.kr

Copyright © 2003 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retrospective study of the effectiveness of traction thoracolumbosacral orthosis (TLSO) in idiopathic scoliosis.

Objective

To compare the results of traction TLSO and conventional TLSO.

Study Design

A retrospective study of the effectiveness of traction thoracolumbosacral orthosis (TLSO) in idiopathic scoliosis.

Objective

To compare the results of traction TLSO and conventional TLSO.

Summary of Literature Review

No report has been published about longitudinal traction and lateral force before cast molding in the nonoperative treatment of idiopathic scoliosis.

Materials and Methods

Twenty- one cases of traction TLSO (group I) and 17 cases of conventional TLSO (group II) were studied. Traction TLSO was made as follows:
1. Cervical traction was applied to the patient standing under the frame with application of lateral force with compression pad.
2. Cast molding.
3. Fabrication of plastic jacket and application of pads. The mean age of group I was 12 years and of group II, 13 years. We evaluated the effectiveness of traction TLSO with Cobb's angle reduction, trunk pain and dyspnea.
Statistical analysis was made with SPSS.

Results

In group I, mean pre- brace Cobb's angle was 31.1 ° and in group II, 29.6°. Flexibility of the curves was 78% and 75%, respectively. Mean reduction rate of Cobb's angle after 3 days of brace application was 59.5% and 15.4%, respectively. One year later, reduction of Cobb's angle was 15.4° in group I and 2.7° in group II. Reduction rate of Cobb's angle after 1year of brace application was 54.2% and 7.9%, respectively. Post- brace pain and dyspnea were similar in both groups.

Conclusion

Traction TLSO was superior to conventional TLSO in terms of angle reduction, but was similar in subjective symptoms.

Keywords: Idiopathic scoliosis, Traction thoracolumbosacral orthosis

REFERENCES

1). Blount WP, Schmidt AC, Keever ED and Leonard ET. The Milwaukee brace in the operative treatment of scoliosis. J Bone Joint Surg. 1958; 40A:511–525.
crossref
2). Labelle H and Dansereau J. Orthotic Treatment of Pediatric Spinal Disorder and Diseases. (in Hsu JD eds. Spine. Spinal Disorders in the Child and Adolescent. Hanley & Belfus, Inc. 1990; 239-251.
3). Bunnell WP, MacEwen GD and Jayakumar S. The Use of Plastic Jacket in the Non-Operative Treatment of Idiopathic Scoliosis. Preliminary Report. J Bone Joint Surg. 1980; 62A:31–38.
4). McCollough NC 3rd, Schultz M and Latta N. Miami TLSO in the Management of Scoliosis: Preliminary results in 100 cases. J Ped Orthop. 1981; 1:141–152.
5). Park J, Houtkin S, Grossman J and Levine DB. A Modified Brace(Prenyl) for Scoliosis. Clin Orthop. 1977; 126:67–73.
6). Winter R and Carlson M. Mordern Orthosis for Spinal Deformities. Clin Orthop. 1977; 126:74–86.
7). Watts HG, Hall JE and Stanish WM. The Boston Brace System for the Treatment of Low Thoracic and Lumbar Scoliosis by the Use of a Girdle without Superstructure. Clin Orthop. 1977; 126:87–92.
crossref
8). Drennen JC, Renshaw TS and Curtis BH. The Thoracic Suspension Orthosis. Clin Orthop. 1979; 139:33–39.
9). Moon MS, Ok IY and Moon SY. The Boston Brace in Adolescent Idiopathic Scoliosis. J Kor Orthop Assoc. 1989; 24:1605–1611.
crossref

Fig. 1.
Tractional TLSO : cervical traction is applied to the patient who stand under the frame with application of lateral force with compression pad.
jkss-10-248f1.tif
Fig. 2.
A. Right thoracolumbar curve of 23 degrees in the prebrace. Fig. 2. B. Traction TLSO was fitted with excellent correction to 1 degree after 3days. Fig. 2. C. Traction TLSO was fitted with excellent correction to 3 degrees after 1year.
jkss-10-248f2.tif
Fig. 3.
A. Right thoracic curve of 36 degrees in the prebrace. Fig. 2. B. Traction TLSO was fitted with excellent correction to 2 degrees after 3days. Fig. 2. C. Traction TLSO was fitted with excellent correction to 4 degrees after 1year.
jkss-10-248f3.tif
Fig. 4.
A. Right thoracic curve of 20 degrees in the prebrace. Fig. 2. B. The Cobb’s angle was 21 degrees after 3days in the treatment with classic orthosis. Fig. 2. C. The Cobb’s angle was increased to 35 degrees after 1year in the treatment with classic orthosis.
jkss-10-248f4.tif
Table 1.
Summary of cases of group I
                  After 1 Year
No. Name Sex Age level Pre Brace Post Brace Reduction Angle Correction Rate(%) Last Follow up Reduction Angle Correction Rate(%)
1 S.H.R. F 11 T5-T12 30 4 26 86 0 30 100
2 L.H.R. F 12 T4-T10 29 9 20 68 15 14 48
3 H.D.R. F 13 T6-T11 24 10 14 58 4 20 83
4 K.D.J. F 13 T4-T9 25 18 7 28 15 10 40
5 L.B.R. F 13 T12-L4 40 16 24 60 17 13 32
6 A.J.H. F 13 T6-T11 31 20 11 35 16 15 48
7 J.S.M. F 13 T7-L2 17 1 16 94 0 17 100
8 J.E.H. F 12 T12-L3 41 35 6 14 28 13 31
9 H.S.A. F 11 T5-T10 34 15 19 55 25 9 26
10 K.D.J. M 12 T6-T12 26 10 16 61 7 19 73
11 K.S.A. F 12 T11-L3 27 0 27 100 9 18 66
12 L.A.R. F 12 T4-T9 39 26 13 33 27 12 30
13 K.Y.J. F 12 T12-L3 30 24 6 20 23 7 23
14 K.H.R. F 13 T10-L3 26 3 23 88 5 21 80
15 N.D.W. M 10 T4-T11 37 24 13 35 13 3 12
16 N.S.J. F 13 T8-L2 28 12 16 57 18 10 35
17 H.E.Y. F 13 T10-L4 40 17 23 57 18 12 30
18 K.H.S. F 12 T5-T10 35 13 22 62 13 22 62
19 J.J.H. F 10 T6-L1 36 18 18 50 20 16 44
20 P.E.M. F 10 T7-L1 36 2 34 94 4 32 88
21 L.K.A. F 11 T10-L3 23 1 22 95 3 20 87
Average     12 31.14 13.24 17.90 59.52 13.33 15.38 54.19
Table 2.
Summary of cases of group II
                  After 1 Year
No. Name Sex Age level Pre Brace Post Brace Reduction Angle Correction Rate(%) Last Follow up Reduction Angle Correction Rate(%)
1 K.K.A. F 12 T12-L3 25 21 4 16 23 2 8
2 C.N.S. F 13 T11-L3 20 16 4 20 18 2 10
3 H.J.T. F 13 T4-12 30 28 2 6.7 26 4 13.3
4 L.M.A. F 13 T6-11 35 30 5 6 32 3 8.5
5 P.E.Y F 14 T6-11 36 33 3 8.3 34 2 5.5
6 P.K.S. F 14 T10-L2 29 24 5 17.2 26 3 10.3
7 N.M.H. F 12 T6-L1 28 21 7 25 22 3 10.7
8 A.D.S. F 13 T6-12 26 23 3 11.5 22 4 15.3
9 K.M.M. F 14 T12-L3 31 21 10 32.3 23 8 25.8
10 K.E.A. F 13 T5-10 28 19 9 32.1 22 6 21.4
11 C.E.Y. F 12 T7-L1 43 41 2 4.6 43 0 0
12 L.H.R. M 11 T8-L2 25 23 2 8 22 3 13.1
13 L.J.A. F 13 T6-11 34 30 4 11.8 30 4 11.7
14 H.E.S. F 13 T4-9 31 26 5 16.1 27 4 11.8
15 J.Y.S. M 14 T11-L3 31 25 6 19.4 27 4 12.9
16 J.E.Y. F 13 T7-L2 31 21 10 32.3 23 8 25.8
17 L.E.A. F 12 T4-T10 20 21 -1 -5 35 -14 -70
Average   13   29.59 24.88 4.71 15.43 26.76 2.71 7.89
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