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Scoliosis: should you wear a corset?


A reference device in child and adolescent scoliosis, the brace is much better fitted and supported thanks to the use of 3D imaging. If diagnosed early, treatment is quick and effective.

Deformation of the spine in children, scoliosis is visible on the x-ray, but also with the naked eye.

“You just have to put the child shirtless, ask him to lean forward and look at his back,”

explains Dr. Vincent Cunin, head of the pediatric orthopedic surgery department at the Woman-Mother-Child Hospital of the University Hospital. from Lyon.

“Asymmetry, responsible for a hump in the back called humpback, is a sign of scoliosis.”

The most common (80%) are idiopathic scoliosis in children and adolescents, for which no cause has been detected, even if a gene is invoked, and the hereditary character is certain.

“There are families of scoliotics,”

recalls Dr. Cunin.


Scoliosis: timid advances in understanding the causes

Scoliosis starts with growth.

“For a long time, a systematic screening examination was done when entering sixth grade.

But for the scoliosis which will evolve and become serious, it is already too late”,

insists the head of department.

However, from compulsory the examination has become recommended by the High Authority for Health.

Dr. Cunin advises parents to carry out the screening themselves from the age of 5-6 years, in addition to that which must be carried out by the general practitioner or the school nurse.

An educational video was even posted on YouTube by the Yves-Cotrel Foundation.

The stakes are high because scoliosis caught late will no longer be able to benefit from corset treatment.

“The earlier the diagnosis, the quicker, simpler and more effective the treatment will be.

Conversely, the more the scoliosis will have evolved, the more it will be necessary to resort to surgery.

Tailor-made in 3D

Far from the image of an imprisoning metal device, the corset has evolved a lot, in particular with, for its manufacture, 3D imaging, reproducing the shape of the trunk, and optical scanner techniques.

“A simple camera and a dedicated application allow you to take the measurements of the corset,

explains Dr. Cunin.

It is also possible, thanks to another software, to digitize and simulate the correction that the corset will bring in order to be the most effective while being the least annoying.

Once the result has been obtained, with a back that appears straight, the real corset is made and then tried on the young patient.

"If we start early, and the angle of curvature is less than 25 or 30°, the treatment can be only nocturnal with very good tolerance."

The brace stabilizes the scoliosis.

It does not straighten it, but blocks its evolution.

Physical activity is recommended, removing the corset once or twice a week, to avoid muscle wasting and stiffness, harmful to the spine.

From adulthood, scoliosis can also develop, for example, in women during weight gain with pregnancy or due to hormonal changes during menopause

Dr Michael Grelat, neurosurgeon at the Clinique du Parc in Lyon

Nearly 20% of scoliosis is said to be secondary, because it is due to a disease such as myopathy, or to a malformation of the vertebrae.

“From adulthood, scoliosis can also evolve, for example, in women during weight gain with pregnancy or due to hormonal changes during menopause,”

recalls Dr. Michael Grelat, neurosurgeon at the Parc clinic in Lyon.

The treatment can also go through the corset.

“In adults, it will be used more for analgesic purposes to reduce mechanical pain,”

explains the practitioner.

But if the scoliosis is very advanced, beyond an angle of 40°, arthrodesis is the reference operation, making it possible to weld the vertebrae together while straightening them.

“The operated area nevertheless remains rigid and the spine loses its flexibility,”

explains Dr. Cunin.

With his team and that of Professor Courvoisier in Grenoble, he introduced an innovative technique called Vertebral Body Tethering (VBT).

This minimally invasive surgery straightens the spine using a flexible cable and uses growth to complete scoliosis correction.

Source: lefigaro

All news articles on 2022-06-23

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