Pediatr. pro Praxi, 2003; 5: 243-247

Klinické vyšetření a léčebné postupy u pacientů s idiopatickou skoliózou

doc. PaedDr. Pavel Kolář
Klinika rehabilitace, UK Praha, 2. lékařská fakulta a FN v Motole, Praha

Keywords: idiopathic scoliosis, corset-therapy, fysiotherapy in scoliosis.

Published: December 31, 2003  Show citation

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Kolář P. Klinické vyšetření a léčebné postupy u pacientů s idiopatickou skoliózou. Pediatr. praxi. 2003;4(5):243-247.

Idiopatická skolióza ohrožuje pacienta po celou dobu jeho kosterního růstu, někdy i po ukončení růstu. Jde o onemocnění, které může začít kdykoliv v této dlouhé časové periodě a kdykoliv se v tomto období může zhoršovat. Někdy i velmi rychle (maligně). Postižení pacienta je rozdílné podle stupně závažnosti i lokalizace zakřivení. Rozvoj progrese onemocnění a stanovení jeho závažnosti je v době jejího vzniku velmi obtížné. Jen část pacientů zachycených s idiopatickou skoliózou dospěje progresí k bodu potencionální klinické významnosti. Pravděpodobnost progrese u pacientů s predisponujícími faktory může dosahovat až 90 %. Mezi faktory, které ovlivňují pravděpodobnost progrese, patří pacientův věk, pohlaví, lokalizace primární křivky, stav měkkých tkání, minimální mozečkové příznaky, kompenzace křivky. Některé studie ukazují, že výsledek terapie je závislý na včasném zahájení léčby. Mezi hlavní konzervativní terapeutické postupy počítáme LTV a korzetoterapii. Při volbě fyzioterapeutických postupů je nutné přihlížet na typ, progresi a velikost křivky, na věk pacienta a jeho spolupráci.

Clinical Investigation and Medical Treatment of Patient-s with Idiopathic Scoliosis

Idiopathic scoliosis (IS) endanger a patient during and after his bone growth period. The IS could occur and clinical signs get worse in any time at this period, sometimes very quickly. The handicapp of a patient is different depending on consequential grading and localisation of spine curvature. Prognosis and grading of IS at the beginning of disease is very complicated. To the point of clinical significance can get just a part of patient-s with IS. Progress probability of IS with high risk factors patiens si about 90%. The main high risk factors are: age, sex, localisation of primary curvature, compensation of curvature, quality of flaccid tissue, minimal cerebellum signs. Some studies show that result of therapy depends on in time treatment. LTV and corset-therapy are the main conservative procedures. The choice of fysiotherapeutic procedures depends on type, progress and size of curvature, age of patient and his compliance.

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