SOSORT Consensus Kyphosis Session - V2 1

www.sosort-lyon.net

CONSENSUS SESSION (stage 1) Standards of management of juvenile & adolescent Kyphosis with corrective braces and physiotherapy in everyday clinics

All Meeting participants are kindly invited to give their contribution at the Sosort Consensus Session on Thursday, May 21, 18.00 - 19.00

METHODS

1. We defined the questionnaire in the Board and the members of the Board who gave suggestions on the questionnaire became co-authors of the paper.

2. The people who answered the questionnaire before the Meeting were listed in the papers.

3. The responsible prepared a draft article approved by all co-author members of the Board (if someone do not agree or do not give input at this stage is not any more a co-author) that is sent before the Meeting to all registered participants.

4. The responsible gave a presentation of the draft article during the Meeting with free discussion that ended in…

5. A final questionnaire to reach the final consensus filled in by the participants to the Consensus.

Your comments are very important to reach the best formulation of the recommendation.

Please read the following questions carefully and choose the answer you consider to be the most suitable for you and your country or state.

You can send this paper:

by post : SIRER – 155 boulevard des Belges 69006 LYON (FRANCE)

Better On Line after creating an account

SOSORT Consensus Kyphosis Session - V2 2

www.sosort-lyon.net

Instructions to create an account In order to register on line, you must first create a user account on the web site www.sosort-lyon.net

Once your account is created, you will receive an email:

"Thank you for registering at SOSORT LYON 2009. Your account is created and must be activated before you can use it.

To activate the account click on the following link or copy-paste it in your browser:

http://www.sosort-lyon.net/xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

After activation you may login to http://www.sosort-lyon.net/ using the following username and password:

Username: xxxxxxxxxxxxxxxxxxx

Password: xxxxxxxxxxxxxxxx"

You will be able to return to the web site and enter your access keys (Username and Password) and get to Consensus ON LINE in the TOP MENU.

Q1 - Bracing and physiotherapy can be useful for Juvenile Kyphosis and modify natural history.

Yes No Blank

Q2 - Do you treat Kyphosis conservatively at your Center?

Yes No Blank

Comment

SOSORT Consensus Kyphosis Session - V2 3

www.sosort-lyon.net

Q3 - Therapeutic aims of physical exercise treatment in patients at risk of brace:

High Priority Medium Priority Low Priority Auto-elongation Back school Coordination Equilibrium Ergonomic General Motor Capacity Hamstring mobilization Mezieres Muscular endurance Muscular strength Neuromotorial control Pectoral stretching Proprioception Self control of posture Sensory motor integration Sport Vertebral mobilization Other

Q4 - Why do you treat Kyphosis?

High Priority Medium Priority Low Priority Aesthetics Back Pain Breathing function Cobb Degree Disability Progression in adulthood Psychological well-being Quality of life Scheuermann Other

Comment

Comment

SOSORT Consensus Kyphosis Session - V2 4

www.sosort-lyon.net

Q5 - Which information do you need before Treatment?

High Priority Medium Priority Low Priority Direct Rigidity (spine) Indirect Shoulder Rigidity Indirect Pelvic Rigidity Cobb Degree (kyphosis) Anatomical localization 1 Pelvic Incidence Disharmony of Kyphosis 2 Local Pain (apex Kyphosis) Family history RMI, Scanner… Other 1 – High thoracic, Medium thoracic, Low thoracic, Thoraco-lumbar 2 - Hyper-Kyphosis without Hyperlordosis

Q6 – Finally bracing: What is your Management?

High Priority Medium Priority Low Priority Before

Specific Physiotherapy Plaster Cast

Moulding Made-to-measure Custom Made Plaster Cast Cad Cam

Structure Day Hospital Hospitalization

Comment

Comment

SOSORT Consensus Kyphosis Session - V2 5

www.sosort-lyon.net

Practical cases

Example 1

13 years, no pain, harmonious Kypho-lordosis

Nothing Control Book-rest Physiotherapy Soft Brace Rigid Brace Plaster Cast Surgery

Example 2

15 years, postural pain, no Scheuermann, low pelvic incidence

Nothing Control Book-rest Physiotherapy Soft Brace Rigid Brace Plaster Cast Surgery

Example 3

16 years, pain, Scheuermann

Nothing Control Book-rest Physiotherapy Soft Brace Rigid Brace Plaster Cast Surgery

SOSORT Consensus Kyphosis Session - V2 6

www.sosort-lyon.net

Example 4

15 years, thoraco-lumbar kyphosis, pain, low pelvic incidence

Nothing Control Book-rest Physiotherapy Soft Brace Rigid Brace Plaster Cast Surgery

Bracing Juvenile & Adolescent Kyphosis

Soft Straightening Back Brace

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

C35

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

SOSORT Consensus Kyphosis Session - V2 7

www.sosort-lyon.net

Milwaukee – Kyphosis

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

Boston Underarm Kyphosis Brace

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

Lyon Kyphosis Brace

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

SOSORT Consensus Kyphosis Session - V2 8

www.sosort-lyon.net

Adjustable Lyon Kyphosis Brace

Use No Use

If you use it: indications (age / flexibility / aetiology /localization ...)

Some Technical Points Use Often Use No Use Cervical Collar Clavicle strap Above Apex Below Posterior upper Level If not apex 1 2 3 How many vertebrae? Yes No Monovalve anterior closure Monovalve posterior closure Bivale lateral closure Only with strap Do you correct lordosis?

How do You correct Lordosis?

SOSORT Consensus Kyphosis Session - V2 9

www.sosort-lyon.net

Do you have some suggestions on the questions already prepared?

Do you want some more questions?

Dr. Pr. Mr. Mrs. Ms. LAST NAME:……………………………………………………………………………………………………………………. First Name:……………………………………………………………………………………………………………………… Institution:………………………………………………………………………………………………….................... Street/Po Box:……………………………………………………………………….………………………………………… Postal code: …………………… City: ………………………………… Country: ………………………………...... Phone: …………………………………………………..….Fax: ……………………......................................... E-mail:……………………………………………………………………………………………………………………………….