Current Status of Surface Electrical Stimulation for Idiopathic Scoliosis
NEWTON C. MC COLLOUGH III, MD*Miami, Florida
Ten years' experience with the "electrospinal orthosis" (ESO) has led to the development of compact systems with an on-off ratio of 5:25 seconds. In 1978, a 21-center study group was formed for patients with idiopathic scoliosis with no prior treatment, immature spines, and curves of 30 to 40 deg. or with 5 deg. of documented progression. Of over 600 patients treated 191 had appropriate curves, primarily thoracic. Seventy-seven percent showed nonprogression or improvement. The Scolitron with a 1:1 on-off ratio is about as effective. The greatest failures were in thoracic curves, the 3-to-11 -year-old group, those with a 0 Risser sign, and with lateral electrode placement. Although half the patients had skin problems, only two percent were discontinued. Four percent were noncompliant. A single curve requires an FDA-approved singlechannel unit. Dual channels suit double curves and thoracic curves by balancing paraspinal contraction at the compensatory lumbar curve. ESO allows normal daytime activities, but depends on the parent to tape the electrodes nightly and is time consuming for physicians. A physical therapist to trouble-shoot and talk to parents is necessary. Remaining questions are: Are the curves which do not respond to ESO those which would not respond to a brace? Are the curves which respond to ESO those which would not progress if untreated?
*University of Miami School of Medicine, Department of Orthopedics and Rehabilitation Box 106960, Miami, FL 33101