Case Report

Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report

Hans-Rudolf Weiss, Manuel Lay, Tamisha Best-Gittens, Marc Moramarco, Mario Jimeranez
South African Journal of Physiotherapy | Vol 77, No 2 | a1588 | DOI: https://doi.org/10.4102/sajp.v77i2.1588 | © 2021 Hans-Rudolf Weiss, Manuel Lay, Tamisha Best-Gittens, Marc Moramarco, Mario Jimeranez | This work is licensed under CC Attribution 4.0
Submitted: 27 May 2021 | Published: 30 November 2021

About the author(s)

Hans-Rudolf Weiss, Schroth Best Practice Academy, Neu-Bamberg, Germany; and, Koob Scolitech GmbH, Neu-Bamberg, Germany
Manuel Lay, Orthopedic Technology, Orthopädietechnik Lay GmbH, Zell-Barl, Germany
Tamisha Best-Gittens, ScolioPhysio Caribbean, Christ Church, Barbados
Marc Moramarco, Scoliosis3DC/Private Practice, Woburn, United States of America
Mario Jimeranez, Private, Sevillano, Havanna, Cuba

Abstract

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.


Keywords

congenital heart disease; scoliosis; physiotherapy; brace treatment; cosmesis

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