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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2007 June;58(3):239-44
Results of the elongation-derotation-flexion (EDF) technique in the management of idiopathic scoliosis in adolescence
Maiello A., Girardo M., Trucchi F., Collo G., Castoldi F., Rossi R.
Divisione Universitaria di Ortopedia e Traumatologia Ospedale Mauriziano, Torino
Aim. The aim of our retrospective study is to evaluate the outcome of elongation-derotation-flexion (EDF) cast technique in management of adolescent idiopathic scoliosis.
Methods. Between 1991 and 2005 we treated 150 patients with no surgical procedure. A cohort of 98 patients (88 females, 10 males) was selected with the following criteria: untreated adolescent idiopathic scoliosis; Cobb angle between 30 and 50°; Risser less than or equal to 3 at the beginning of treatment; EDF cast technique like the only and first treatment; no high thoracic curves and thoracic kyphosis less than 20° were included. The mean age at the beginning of the treatment was 13.4 years (range between 10 and 17 years SD: 1.56). The Risser sign was 0.1 or 2 in 70.4% of cases. There were 20 thoracic, 19 thoraco-lumbar, 15 lumbar and 44 double major curves. The mean Cobb angle at the beginning of treatment was 37.4° (minimum 30°, maximum 50°). The percentage of reduction of the Cobb angle after the last correction defines the outcome of the EDF technique. Bivariable analysis was performed with the Student’s t-test and the analysis of the variance, considering a statistical significance of P<0.05.
Results. The mean percentage of reduction was 42.5% (SD 20.9, minimum 10%, maximum 100%), corresponding to mean Cobb difference of 15.9° (P<0.01). Significant corrections were observed in lumbar (48.2% SD: 20), thoracolumbar (44.8% SD: 18.9) and thoracic single curves (40.1% SD: 20,3) pattern. The mean correction values are >30% in 70.5% of cases. No differences were observed in reduction by gender, age, Risser sign or curve patterns.
Conclusion. On the basis of these results, we can confirm that the EDF cast technique is an excellent corrective therapy for idiopathic scoliosis in adolescence, but only if followed by the appropriate brace.