The spine lateral bending and the dynamic chest compression principles for concomitant orthotic treatment of scoliosis and pectus deformities

OBJECTIVE:To investigate a concomitant orthotic treatment for coexisting scoliosis and pectus deformities. No detailed study on such concomitancy was found in literature. METHODS: A spine bending brace for use day and night, and dynamic chest compressor orthoses for use four hours a day, along with one hour of exercises, were prescribed. From 638 adolescents, 25 met the inclusion criteria for a retrospective study. Two groups of patients were identified: A (15 compliant patients) and B (10 non-compliant patients). The mean follow-up was 27 months for group A and 21 months for group B. Pre and post- treatment clinical signs of scoliosis and pectus were photographically compared. The scoliosis had radiologic evaluation by Cobb angle and Nash-Moe classification for vertebral rotation. RESULTS: For both conditions, scoliosis and pectus deformities, the outcome was significantly better in the compliant group (p<0.001 for both). One highly compliant adolescent with a 52º scoliosis and pectus carinatum, showed a surprising improvement to 27º after 40 months of treatment, when chest braces were interrupted and the weaning from the spine brace has started. A 34º scoliosis was maintained after 60 months of follow-up, with vertebral rotation improvement. CONCLUSION: The concomitant orthotic treatment yielded preliminary positive results for compliant patients, warranting investigation continuity.