CASE STUDIES

Cobb angle reduction after bracing combined with Schroth therapy

  • 10 years 9 months – initial diagnosis at 32 degrees lumbar and 17 degrees thoracic curves. Patient started treatment with Schroth physical therapy and WCR brace. The brace was effectively reducing the curve.

  • At 6 months of treatment the curve was reduced to 19 degrees.

  • At 16 months of treatment to curve was less then 10 degrees. Treatment continued for 3.5 years till weaning off the brace.

  • At the end of treatment after weaning off the brace the curve remained significantly lower than at the initial diagnosis.

  • Progression of the curve was stopped, and surgery was avoided.

Kyphosis – PT only

  • 15.5 years of age – initial diagnosis of significant hyper kyphosis – 70 degrees. Surgical warning if curve progresses further. Brace was not prescribed as the doctor did not think it would be helpful at this stage of growth. Schroth method PT was done for 1 year with good home program compliance.

  • At 16.5 years of age – kyphosis reduced to 60 degrees – surgery is out of question. Great postural and cosmetic improvement. Increased fitness level and no pain.

Cobb angle reduction with Schroth therapy delivered virtually and night time bracing administered at the end of growth

  • At 10 years of age with the Cobb angle was diagnosed at 22 degrees. The patient has started scoliosis specific exercises but stopped after 6 months as it was difficult to focus on postural work.

  • At the age of 15 Cobb angle progressed to 42 degrees. Therapy restarted shortly before pandemic. We transitioned to virtual therapy being forced to teach and learn postural corrections, exercise set ups and breathing techniques on line. Virtual sessions were provided 1- 2 x week for 5 months and home program was followed. The patient was recommended to wear a Rigo type brace at night to improve flexibility of his curve.

  • At the 6 months follow up the curve reduced to 25 degrees. Therapy continued for the next 2 years with the average frequency of 2 x month and the patient was gradually weaned off the brace. Prior to final X-rays there was no treatment provided for 4 months.

  • At 2 years 8 months follow up (age 18) the curve reduction remained stable at 25 degrees Cobb angle and no further follow ups were recommended by orthopaedic doctor.

This case is a proof that virtual therapy can be highly effective and that bracing at the end of growth can be very helpful, even if it is administered at nighttime only.

Juvenile scoliosis reduced with Schroth therapy only – Bracing avoided

  • At the age of 9 years the patient was diagnosed with scoliosis, and she was recommended “wait and see” observational approach.
  • At the age of 11 .5 years the curve progressed to 23 degrees at thoracic and 25 degrees at lumbar region. The doctor recommended to start bracing and scoliosis specific exercises. The family preferred to try Schroth therapy first. PT was delivered 2 x week for 6 weeks period.

  • At the follow up in 6 weeks significant reduction of the curve was observed from to 13 /15 degrees. Bracing was no longer necessary, and therapy continued through the next several years on average 1 x week, first individually and then in group format.

  • Towards the end of treatment, the curve gradually progressed to the numbers that were close to initial diagnosis, but it never exceeded it. Surgery was prevented and bracing was completely avoided. The patient was happy and satisfied with treatment outcome.

Towards the end of treatment, the curve gradually progressed to the numbers that were close to initial diagnosis, but it never exceeded it. Surgery was prevented and bracing was completely avoided. The patient was happy and satisfied with treatment outcome.

Complete curve reduction with PT only

  • The patient was 12 years old female referred to treatment due to mild scoliosis and postural asymmetry. Cobb angle was 24 degrees which is very close to bracing.

  • After 10 months of physical therapy treatment (Schroth method) the follow up X-rays demonstrated almost complete reduction of the curve.

  • Bracing was avoided and PT was delivered for another 6 months for strengthening / stabilization.

Curve reduction after bracing and Schroth method physical therapy

  • Patient was diagnosed at 13.5 years of age (Cobb angles 21 thoracic and 25 lumbar). The brace was prescribed and received, but it was very uncomfortable, and the patient refused to wear it. The family asked to try Schroth method PT instead and he started at the age of 14.

  • We tried for 3 months, but the curve progression continued reaching 34.5 degrees. Patient agreed to try Rigo type brace and was able to tolerate it well.

  • In 6 months of Schroth therapy combined with Rigo brace there was a significant curve reduction from 34.5 to 20.3 degrees. PT and brace treatment discontinued at the age of 16 and results were mostly retained. Surgery was avoided and curve stability maintained.

Adolescent idiopathic scoliosis treated with WCR brace and Schroth therapy

  • Patient was 13.5 years old at the time of diagnosis and at the start of treatment. She was treated with WCR brace and Schroth method therapy.

  • After completion of growth gradual bracing time reduction was initiated and therapy was expanded to scoliosis specific Pilates exercises.

  • Weaning off the brace was very gradual – first reaching night wear and then gradually reducing the number of nights per week. At the end of treatment significant curve reduction was retained.

Juvenile scoliosis treated with NYRC brace and scoliosis specific exercises

  • The patient was diagnosed at the age of 10 with severe juvenile scoliosis that was within surgical range.

  • She was advised to consider growing rods procedure but chose to try conservative approach first.

  • After 3 years of bracing with NYCR brace and some PSSE condition resolved and surgical prognosis was lifted.

Why this case was so successful?

  1. Young age, good flexibility and  excellent in brace correction
  2. Excellent brace compliance 
  3. Good therapy effort initially
  4. Good physical fitness effort to support bracing 

Adolescent kyphosis treated with part time bracing and PSSE

  • The child was diagnosed at the age of 12 with severe kyphosis. Treatment was initiated with night brace and PSSE.

  • The curve gradually decreased from 72 to 38 degrees at discharge in 3 years.

  • Treatment was not difficult as the brace was used part time only and kyphosis completely resolved.