Effect of the use of corrective thoracolumbosacral orthosis on the evolution of scoliosis in patients with cerebral palsy GMFCS IV-V. Dynamic Retrospective Cohort Study

Abstract

Introduction: Scoliosis is a frequent deformity in children with cerebral palsy (CP), it is progressive and negatively affects functional capacity. The management of scoliosis in curves from 45° is surgical management and is aimed at solving the problem of the spine. In telethon, orthotic management is used in moderate and severe curves with thoraco-lumbo sacral orthosis (TLSO). In this regard, the present study sought to compare the evolution of scoliosis in patients treated with TLSO for 12 months with the natural history of scoliosis. Materials (or patients) and Methods: Study of two dynamic cohorts of patients with a diagnosis of CP, scoliosis greater than 20° and indication for TLSO between January 2017 and December 2019 at the Teletón Institute (IT) Santiago. The scoliotic curve was evaluated for one year using the Cobb method and the median time elapsed due to the presence of an ad­verse event (change in TLSO). Results: Statistically significant differences were identified in the scoliotic curve between the baseline measurement and the first control, and between the first control and the last. There were no demographic or clinical variables significantly associated with variations in the scoliotic curve. A significant difference was identified between the survival curves of those who presented an adverse event and those who did not. Conclusions: The TLSO stopped the progression of the scoliotic curve after 12 months of use. The lack of comparable cases made it impossible to compare the results obtained with the natural history of scoliosis described in the available theoretical background.