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Case Reports
. 2017 Dec 29:11:1490-1499.
doi: 10.2174/1874325001711011490. eCollection 2017.

Cobb Angle Reduction in a Nearly Skeletally Mature Adolescent (Risser 4) After Pattern-Specific Scoliosis Rehabilitation (PSSR)

Marc Moramarco  1 , Kathryn Moramarco  1 , Maja Fadzan  1
Affiliations
Case Reports

Cobb Angle Reduction in a Nearly Skeletally Mature Adolescent (Risser 4) After Pattern-Specific Scoliosis Rehabilitation (PSSR)

Marc Moramarco et al. Open Orthop J. .

Abstract

Introduction: It has long been said that exercise-based rehabilitation for scoliosis is ineffective, however, these reports studied general exercises. This case report is a prospective one-year follow-up of a nearly skeletally mature adolescent female (Risser 4) with idiopathic scoliosis treated with Pattern-Specific-Scoliosis Rehabilitation (PSSR).

Methods: The 15-year old patient recommended for surgery (initial Cobb angle of 45°) completed a 16-hour scoliosis-specific back school (according to Schroth Best Practice®), over the course of five weeks. She continued with her program at home, and followed up with the lead author after 6 months and 1 year.

Results: The patient achieved a 13° reduction in her primary thoracic Cobb angle. Postural improvement and reduction in trunk rotation (ATR) was also achieved (-4° in the thoracic spine, and -5° in the lumbar spine).

Conclusion: Pattern-specific scoliosis rehabilitation (PSSR) works to reduce the asymmetrical load caused by scoliosis. PSSR is effective in stabilizing Cobb angle, and can, in some cases, reduce Cobb angle in adolescents. Patients recommended for surgery may be candidates for conservative treatment. This case suggests that the practice of discontinuing conservative treatment at Risser stage 4 should be re-evaluated.

Keywords: Adolescent idiopathic scoliosis; Pattern-specific scoliosis rehabilitation; Schroth Best Practice; Schroth method; Scoliosis-specific exercise.

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Figures

Fig. (1)
Fig. (1)
a) February 2016, b) April 2016, c) October 2016, d) April 2017. X-ray b is the patient’s initial x-ray prior to beginning her PSSR program. X-ray d was taken one year later. The patient’s x-rays were performed at one of two local hospitals in the metropolitan Boston area.
Fig. (2)
Fig. (2)
Comparison photos taken at initial examination and at one-year follow-up. Follow-up photos (2nd and 4th images from left) show improved body symmetry and reduced rotation.
See this image and copyright information in PMC

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