REVIEW  PEDIATRIC ORTHOPEDICS 

Minerva Ortopedica e Traumatologica 2019 March;70(1):27-31

DOI: 10.23736/S0394-3410.19.03899-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Perspectives in the field of orthopedic and surgical management of adolescent idiopathic scoliosis

Aurélien COURVOISIER ✉

Grenoble Alps Scoliosis and Spine Center, Grenoble, France

Adolescent idiopathic scoliosis (AIS) is a spine 3D deformity. The etiology of AIS is not known, and there is no curative treatment. Our objective was to explain the main evolutions in the field of AIS management during the last decade and what we foresee for the next one. Without screening no treatment is possible. Once the clinical detection is done, the EOS X rays system makes it possible to obtain a 3D shape of the spine in a standing position that enables us to obtain predictive factors of progression. It will then be possible to start a brace for patient at risk of progression only. At this point, we will use brace simulators after creating a high-fidelity 3D “avatar” of the patient with the combination of the internal and external shape of the trunk. Patient-specific conception of the brace will then be possible. For patients with the most severe curves, we will switch to minimal invasive techniques like vertebral body tethering. And for patients with the smallest curves dynamic braces will improve the performance of physiotherapy and exercises. The whole concept is to decrease the rate of fused spine for AIS during the next decade.

KEY WORDS: Scoliosis - Braces - Adolescent