Παρουσίαση έρευνας στο Συνέδριο της Eurospine, στην Βιέννη με τίτλο: “Brace and PSSE for Adolescent Idiopathic Scoliosis treatment: A prospective study following SRS criteria”

Ο Νίκος Καραβίδας συμμετείχε στο Ετήσιο Συνέδριο της Eurospine, που διοργανώθηκε στην Βιέννη από 6 έως 8 Οκτωβρίου 2021, παρουσιάζοντας την έρευνα του με τίτλο:

” Brace and Physiotherapeutic Scoliosis Specific Exercises (PSSE) for Adolescent Idiopathic Scoliosis treatment: A prospective study following Scoliosis Research Society (SRS) criteria “

Το συνέδριο της Eurospine αποτελεί το σημαντικότερο χειρουργικό επιστημονικό συνέδριο στην Ευρώπη για την αντιμετώπιση των παθήσεων της σπονδυλικής στήλης, με συμμετοχή των κορυφαίων Χειρουργικών Ορθοπεδικών από όλο τον κόσμο, όπως ο Lawrence Lenke, ο Jurgen Harms κ.α. Ο Νίκος Καραβίδας ήταν ο μοναδικός εκπρόσωπος της Ελλάδας καθώς και ο μοναδικός Φυσικοθεραπευτής σε όλο το συνέδριο με προφορική ανακοίνωση, κάτι που αναμφίβολα συνιστά σημαντική τιμητική διάκριση.

 

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Η ομιλία του παρουσιάστηκε την Παρασκευή 8 Οκτωβρίου 2021, στην θεματική ενότητα “Risk factors, safety & new techniques”, με moderator τον Dr. Ahmet Alanay, από την Τουρκία, ο οποίος εκλέχτηκε ως ο επόμενος Πρόεδρος της Eurospine. Ως γνωστόν, ο κ. Καραβίδας αποτελεί επίσης Faculty Member για το Eurospine Diploma in Interprofessional Spine Care (EDISC).

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Παρακάτω μπορείτε να δείτε την περίληψη της έρευνας:

Background: A growing scientific evidence for conservative treatment of AIS has recently occurred, using PSSE for mild and bracing for moderate curves. Bracing have proved its superiority to natural history and is recommended by SRS for Cobb angles > 25ο. Few studies have used a combination of PSSE and bracing, showing significantly better results than bracing alone.

Objective: Our aim was to investigate the effectiveness of bracing along with PSSE for AIS treatment. The main goal was to halt progression.

Methods: Prospective study, enrolling all eligible subjects from a prospective database. SRS research inclusion criteria were used (>10 years, 25ο – 40ο, Risser 0-2, < 1-year post-menarche, no prior treatment). 102 consecutive patients (87 females-15 males, mean age 12.8 years, Risser 0.48, Cobb Thoracic 29.2ο, Lumbar 27.8ο) followed treatment with Cheneau type brace and PSSE. Average follow-up time was 26.4 months. A scale from A to C was used to evaluate compliance with brace and PSSE (A: full-compliant, B: partially compliant, C: non-compliant). A threshold of 5ο defined progression or improvement. 7 subjects dropped-out (6.8%), so finally 95 patients included for statistical analysis, using paired t-test.

Results: 62 patients (65.3%) remained stable, 22 improved Cobb angle >5ο (23.2%) and 11 progressed (11.5%). The mean in-brace correction (IBC) was 49.7% for thoracic curves and 61.7% for lumbar curves, post-treatment thoracic Cobb was 29.9ο and lumbar 27ο. A subsequent analysis for the progressed cases revealed that IBC was lower than average (31.7% for thoracic and 34.4% for lumbar curves), 9 patients (81.8%) were classified as C for brace compliance and 7 patients (63.6%) as C for PSSE compliance. Only 4 subjects (3.9%) progressed above 40ο, reaching the surgical indication range. Another analysis for the full-compliant group, both for brace and PSSE (62 participants – 65,3%), showed significantly greater effectiveness (p=0.005) than overall average, as 44 patients (70.9%) stabilized Cobb angle, 18 (29.1%) improved and none progressed (0%).

Conclusion: A combination of bracing and PSSE can effectively treat AIS, according to SRS inclusion criteria. 88.5% of patients did not progress more than 5ο and only 6.4% overpassed surgical indication range. IBC and compliance are the most important prognostic factors for successful treatment result. Our multi-professional approach probably enhanced adherence to treatment protocol. Early detection of AIS is also necessary for increased possibilities of effective conservative treatment. Future randomized controlled studies, with brace and PSSE, are recommended to provide stronger scientific evidence.

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