支具治疗脑瘫儿童脊柱侧凸的系统综述。

IF 1.6 4区 医学 Q3 ORTHOPEDICS
Journal of Childrens Orthopaedics Pub Date : 2025-08-27 eCollection Date: 2025-10-01 DOI:10.1177/18632521251361320
Niels Merkelbach, Alix De Pauw, Anja Van Campenhout
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引用次数: 0

摘要

目的:脊柱侧凸是脑瘫患者的一种常见疾病,其特征是由于肌肉张力降低而无法维持脊柱对齐。随着时间的推移,这种渐进式弯曲成为结构性的,导致身体损伤和日常活动的挑战。因此,治疗干预是必不可少的。从历史上看,支架疗法已被广泛应用,但其疗效仍不确定。方法:对4个数据库进行系统综述,汇总与支具治疗脑瘫患者相关的所有研究和综述。每篇文章由两名研究人员独立评估,并使用SIGN工具进行评估。结果:纳入8项研究,包括6项回顾性研究和2项前瞻性研究,均被评为“可接受”或“高质量”。支具治疗显示出暂时的积极效果,在使用支具期间观察到Cobb角的改善,特别是在15岁以下的患者中,由于脊柱不完全成熟。然而,这种改善是短暂的,因为一旦支架被移除,Cobb角就会增加,从而降低其有效性。此外,支架疗法通过改善姿势和减轻疼痛对生活质量产生积极影响,尽管这些好处也会随着时间的推移而减少,可能导致生活质量下降。结论:支具治疗可以暂时缓解脑瘫患者的身体和日常生活挑战。然而,其影响不是持续的,需要长期管理的手术技术。这是一项对二级研究或结果不一致的一级研究的系统综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bracing for scoliosis in children with cerebral palsy-a systematic review.

Purpose: Scoliosis is a prevalent condition among individuals with cerebral palsy, characterized by an inability to maintain spinal alignment due to diminished muscle tone. This progressive curvature becomes structural over time, resulting in physical impairment and challenges in daily activities. Consequently, therapeutic intervention is essential. Historically, brace therapy has been extensively utilized, but its efficacy remains uncertain.

Methods: A systematic review was conducted across four databases to compile all relevant studies and reviews pertaining to brace therapy in cerebral palsy patients. Each article was independently assessed by two researchers and evaluated using the SIGN tool.

Results: Eight studies were included, comprising six retrospective and two prospective studies, all rated as "acceptable" or "high quality." Brace therapy demonstrated a temporary positive effect, with improved Cobb angles observed during brace usage, particularly in patients under 15 years of age, due to incomplete spinal maturation. However, this improvement is transient, as Cobb angles tend to increase once the brace is removed, diminishing its effectiveness. In addition, brace therapy positively impacts quality of life by enhancing posture and reducing pain, although these benefits also diminish over time, potentially leading to a decline in quality of life.

Conclusions: Brace therapy offers temporary relief for physical and daily life challenges associated with cerebral palsy. However, its effects are not sustained, necessitating operative techniques for long-term management. This was a systematic review of Level-II studies or Level-I studies with inconsistent results.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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