J Korean Soc Spine Surg.  2003 Sep;10(3):248-254. 10.4184/jkss.2003.10.3.248.

Result of Traction Thoracolumbosacral Orthosis in Idiopathic Scoliosis

• Park WW
• Nam TW
• Ahn SJ
• Yoo SH
• Moon HG

• KMID: 2209693
• DOI: http://doi.org/10.4184/jkss.2003.10.3.248

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. 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 degrees and in group II, 29.6 degrees. 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 degrees in group I and 2.7 degrees in group II. Reduction rate of Cobb`s angle after 1 year 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.

Keyword

Idiopathic scoliosis; Traction thoracolumbosacral orthosis

MeSH Terms

Braces
Dyspnea
Fungi
Humans
Orthotic Devices*
Plastics
Pliability
Retrospective Studies
Scoliosis*
Traction*
Plastics

Figure

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  Fig. 1. Tractional TLSO : cervical traction is applied to the patient who stand under the frame with application of lateral force with compression pad.

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  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.

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  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.

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  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.

Reference

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.

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.

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.