Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report
Introduction: This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD). Patient presentation, management and outcome: Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2021-11-01
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| Series: | South African Journal of Physiotherapy |
| Subjects: | |
| Online Access: | https://sajp.co.za/index.php/sajp/article/view/1588 |
| _version_ | 1828410844253257728 |
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| author | Hans-Rudolf Weiss Manuel Lay Tamisha Best-Gittens Marc Moramarco Mario Jimeranez |
| author_facet | Hans-Rudolf Weiss Manuel Lay Tamisha Best-Gittens Marc Moramarco Mario Jimeranez |
| author_sort | Hans-Rudolf Weiss |
| collection | DOAJ |
| description | Introduction: This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD).
Patient presentation, management and outcome: Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve of 65° Cobb. Because of the high risk for progression, immediate brace treatment was proposed as the father declined surgery. The patient received intensive treatment according to the Schroth Best Practice® programme and a Gensingen Brace® designed for large thoracic curves. Over the 18 months following the initial visit, she received two additional braces. As a result, the progression of the main curve was prevented. The patient continues to maintain an improved cosmetic result and is currently at a Risser 2.
Conclusion: Surgery performed for CHD in rare cases may lead to stiff spinal deformity as a consequence of that surgery. Progression of a severe and stiff curve was prevented during the most vulnerable phase of the pubertal growth spurt with an improved clinical result. Therefore, we assume that the patient may have a normal life in adulthood with minor restrictions only. Supported by pattern-specific high correction exercises and braces, these typical single thoracic curves can be re-compensated to a more balanced appearance, less prone to progression in adulthood.
Clinical implications: Because of the relative high risks of spinal fusion and the long-term unknowns of such an intervention, high-impact conservative treatment should be implemented first before surgical correction is considered. |
| first_indexed | 2024-12-10T12:18:22Z |
| format | Article |
| id | doaj.art-1aae10004be4498aaf2e9e5f0d5ed494 |
| institution | Directory Open Access Journal |
| issn | 0379-6175 2410-8219 |
| language | English |
| last_indexed | 2024-12-10T12:18:22Z |
| publishDate | 2021-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Journal of Physiotherapy |
| spelling | doaj.art-1aae10004be4498aaf2e9e5f0d5ed4942022-12-22T01:49:09ZengAOSISSouth African Journal of Physiotherapy0379-61752410-82192021-11-01772e1e810.4102/sajp.v77i2.15881469Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case reportHans-Rudolf Weiss0Manuel Lay1Tamisha Best-Gittens2Marc Moramarco3Mario Jimeranez4Schroth Best Practice Academy, Neu-Bamberg, Germany; and, Koob Scolitech GmbH, Neu-BambergOrthopedic Technology, Orthopädietechnik Lay GmbH, Zell-BarlScolioPhysio Caribbean, Christ ChurchScoliosis3DC/Private Practice, Woburn, United States of AmericaPrivate, Sevillano, HavannaIntroduction: This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD). Patient presentation, management and outcome: Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve of 65° Cobb. Because of the high risk for progression, immediate brace treatment was proposed as the father declined surgery. The patient received intensive treatment according to the Schroth Best Practice® programme and a Gensingen Brace® designed for large thoracic curves. Over the 18 months following the initial visit, she received two additional braces. As a result, the progression of the main curve was prevented. The patient continues to maintain an improved cosmetic result and is currently at a Risser 2. Conclusion: Surgery performed for CHD in rare cases may lead to stiff spinal deformity as a consequence of that surgery. Progression of a severe and stiff curve was prevented during the most vulnerable phase of the pubertal growth spurt with an improved clinical result. Therefore, we assume that the patient may have a normal life in adulthood with minor restrictions only. Supported by pattern-specific high correction exercises and braces, these typical single thoracic curves can be re-compensated to a more balanced appearance, less prone to progression in adulthood. Clinical implications: Because of the relative high risks of spinal fusion and the long-term unknowns of such an intervention, high-impact conservative treatment should be implemented first before surgical correction is considered.https://sajp.co.za/index.php/sajp/article/view/1588congenital heart diseasescoliosisphysiotherapybrace treatmentcosmesis |
| spellingShingle | Hans-Rudolf Weiss Manuel Lay Tamisha Best-Gittens Marc Moramarco Mario Jimeranez Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report South African Journal of Physiotherapy congenital heart disease scoliosis physiotherapy brace treatment cosmesis |
| title | Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report |
| title_full | Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report |
| title_fullStr | Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report |
| title_full_unstemmed | Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report |
| title_short | Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report |
| title_sort | conservative treatment of a scoliosis patient after two heart surgeries in early childhood a case report |
| topic | congenital heart disease scoliosis physiotherapy brace treatment cosmesis |
| url | https://sajp.co.za/index.php/sajp/article/view/1588 |
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