Ann Rehabil Med.  2018 Dec;42(6):863-871. 10.5535/arm.2018.42.6.863.

Correlation of Radiographic and Patient Assessment of Spine Following Correction of Nonstructural Component in Juvenile Idiopathic Scoliosis

• Lee JG
• Yun YC
• Jo WJ
• Seog TY
• Yoon YS

• KMID: 2448908
• DOI: http://doi.org/10.5535/arm.2018.42.6.863

Abstract

OBJECTIVE
To evaluate the association between progression of curvature of scoliosis, and correction for functional component in patients with juvenile idiopathic scoliosis (JIS).
METHODS
We retrospectively reviewed medical data of patients prescribed custom molded foot orthosis (FO) to correct inequality of RCSPA (resting calcaneal stance position angle), and chose 52 patients (26 females, 26 males) with Cobb angle ≥10° in radiology and uneven pelvic level at iliac crest by different RCSPA (≥3°) as a factor of functional scoliosis. They had different hump angle ≥5° in forward bending test, for idiopathic scoliosis component. Their mean age and mean period of wearing FO were 79.5±10.6 months and 18.6±0.70 months.
RESULTS
Cobb angle was reduced from 22.03°±4.39° initially to 18.86°±7.53° after wearing FO. Pelvis height difference and RCSPA difference, were reduced from 1.07±0.25 cm initially to 0.60±0.36, and from 4.25°±0.71° initially to 1.71°±0.75° (p < 0.01). Cobb angle improved most in 9 months. However, there was no significant improvement for those with more than 25° of Cobb angle initially. Mean Cobb angle improved in all age groups, but patients less than 6 years had clinically significant improvement of more than 5°.
CONCLUSION
JIS can have functional components, which should be identified and managed. Foot orthosis is useful in correcting functional factors, in the case of pelvic inequality caused by different RCSPA, for patients with juvenile idiopathic scoliosis.

Keyword

Scoliosis; Foot orthoses; Leg length inequality

MeSH Terms

Female
Foot Orthoses
Fungi
Humans
Leg Length Inequality
Pelvis
Retrospective Studies
Scoliosis*
Socioeconomic Factors
Spine*

Figure

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  Fig. 1. Resting calcaneal stance position angle difference.

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  Fig. 2. Functional foot orthosis.

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  Fig. 3. Before orthosis (A) and after orthosis (B).

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  Fig. 4. Changes in the angle of the spine, a 9-year-old wearing foot orthosis for 20 months. (A) Before and (B) after treatment.

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  Fig. 5. Changes in pelvic height differences and Cobb angle during each time point. *p<0.05.

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