Tratamiento de la escoliosis de crecimiento acelerado con corset de yeso. Reporte de una serie de casos

Abstract

The technique of flexion, extension and derotation, (EDF) has been described for the correction of accelerated progression scoliosis. This technique consists in the application of a corset after performing maneuvers of flexion, extension and derotation of the spine. A level of correction of the scoliotic curve of most patients who can tolerate cast treatment has been observed. Objective: The purpose of this study is to analyze a series of five cases in pediatric patients (up to 5 years) in whom the EDF technique has been used in the Baca Ortiz Hospital in Quito, Ecuador, from January to August 2018. It is detailed the procedure performed, as well as the placement and angular values of each of the patients and the level of correction achieved. Materials and methods: Observational retrospective study in 5 cases of patients diagnosed with Accelerated Growth Scoliosis in children under 5 years of age who have not been previously instrumented that meet the criteria of the disease and do not present a contraindication to the use of corsets. The information was collected and the average of the variables to be studied was calculated. Results: In the five patients studied, between 2 and 4 years old, with scoliosis of accelerated growth idiopathic, syndromic or neuromuscular origin, an average correction of 44% was found in the Cobb angle in their initial treatment. It was observed that patients who respond better to treatment are patients with syndromic scoliosis with thoracolumbar curves and two years of age, probably due to the maturity of their bony system. Conclusions: The placement of cast corset for scoliosis with FED technique allows the correction of accelerated progression scoliosis in a range greater than 40% of the Cobb angle. However, it has been possible to show that the correction is not permanent and may recur with the patient's growth. In each case, an adequate assessment is required to decide the treatment. The cast would be an option to prolong the age for making surgery that will be required.