Prevalencia de escoliosis pediátrica en pacientes de 2-18 años atendidos en el servicio de traumatología del Hospital Roberto Gilbert Elizalde desde el año 2013- 2017.

Abstract

The prevalence of scoliosis in Ecuador has not been registered, while the hospital Roberto Gilbert Elizalde is one of the few pediatric hospitals that offer treatment for this pathology,that is why it is decided to determine the general prevalence of scoliosis and, according to the type of scoliosis, to characterize by age, sex, Cobb angle, degree of severity of the curvature, type of treatment performed, as well as other characteristics of each type of scoliosis. Methodology An observational, retrospective, cross-sectional, descriptive and analytical study of patients in the traumatology outpatient service of the Roberto Gilbert Hospital was carried out from 2013 to 2017. The medical records were reviewed to build a database. Results The general prevalence of scoliosis was 125 (0.2%) with the validated study and 1,7% without the validated X-ray study. Prevalence was obtained according to the etiological classification: 75 (60%) corresponded to idiopathic scoliosis, 22 (21.6%) congenital, 22 (21.6%) neuromuscular and 6 (4.8%) miscellaneous. According to sex, 95 cases (76%) were female, and 30 cases (24%) male with a mean age of 11.57 years (SD ±27.9), whose mean Cobb angle is 56.5° ( SD ±27.9), 17.9°(SD ± 25.6). The most frequent degree of severity was severe and the type of treatment used depended on the type of scoliosis. The distribution of the curvature pattern according to the convexity in idiopathic type scoliosis was right dorsal left lumbar patterns with 31 (41.3%), the neuromuscular a right and left thoracolumbar pattern and in Congenital, right dorsal and right dorsal left lumbar both with 4 (18.2%) and miscellaneous the right dorsal pattern with 2 (33.3%). The characterization of the idiopathic were 36 cases (46%, neuromuscular had 12 (54.5%) and miscellaneous 2 (33.3%) with pelvic dysmetria; and in the congenital 10 (45.5%) symmetry. In shoulder measurement, idiopathic scoliosis with 23 cases (37.3%); in the neuromuscular with 7 cases (31.8%) due to asymmetry due to elevation of the right shoulder, and congenital 7 cases (31.8) And miscellaneous 3 patients (50%) asymmetric without specifying. In the foot deformity, idiopathic scoliosis prevails flat foot 12 (16%) and Neuromuscular equine foot with 1 case (14.5%) Congenital with pes cavus with 5 (22.7%). Coronal balance in idiopathic scoliosis corresponds to 36 (48%), neuromuscular 8 (36.4%), congenital 11 (50%) neutral and miscellaneous 4 (66.7%) neutral cases, while sagittal balance in All types of scoliosis result in a predominance of negative balances in idiopathic 57.3%, neuromuscular 36.4%,congenital 36.4% and 33.3% miscellaneous. According to the King Classification system, we obtained type 3 with 26 cases (34.7%) and Lenke type 1 main thoracic with 10 (13,3%) patients. Conclusion It is concluded that the prevalence 1.7% without the validated study of panoramic X-ray of the spine and 0.2% using the validated study. The most prevalent sex was female and the age at puberty. The most frequent degree of severity of the curvature was severe. The most common scoliosis subtype was idiopathic scoliosis and in the type of treatment used, its prevalence depended on the etiological type of scoliosis, as well as its characteristics. It is recommended for future prevalence studies to consider all the imaging studies to assess the prevalence of scoliosis in Ecuador and teach professionals to order the validated X Ray, in addition to studying a more representative population that includes hospitals and educational centers to assess the prevalence of scoliosis. need to create Scoliosis Units for orthopedic and surgical treatment.