Escoliose Idiopática do Adolescente: Diagnóstico e Tratamento Conservador
DOI :
https://doi.org/10.25759/spmfr.302Mots-clés :
Adolescente, Braquetes, Escoliose/ diagnóstico, Escoliose/diagnóstico por imagem, Escoliose/ reabilitação, Escoliose/tratamentoRésumé
A escoliose idiopática do adolescente (EIA) consiste numa deformidade tridimensional da coluna vertebral com desvio lateral da curva mais do que 10o de magnitude em plano frontal, sem etiologia conhecida e com apresentação a partir dos 10 anos de idade. A avaliação clínica requer a exclusão de outras etiologias. A escolha do tipo de tratamento está dependente da magnitude da curva e do potencial de crescimento remanescente. O tratamento conservador tem como principais objetivos o controlo da progressão da curva, a prevenção de complicações futuras, a melhoria do aspeto estético e da qualidade de vida do doente. Das estratégias disponíveis para tratamento conservador aquela que apresenta maior evidência científica é a ortotetização, particularmente as ortóteses rígidas. Existe uma relação dose-resposta com a ortotetização sendo a baixa adesão ao tratamento um dos maiores obstáculos à sua eficácia pelo que é imprescindível a adequada monitorização do tratamento. A utilização de sensores de monitorização eletrónica incorporados nas ortóteses de tronco mostra-se ser uma estratégia de monitorização eficaz. Os exercícios específicos para a escoliose, aplicados de forma isolada ou em associação com o uso de ortótese, apresentam também evidência científica, mas em menor grau que a ortotetização. O método de Schroth e a abordagem Scientific Exercise Approach to Scoliosis são abordagens que apresentam estudos de maior qualidade a suportar os benefícios no controlo da EIA. A gestão do tratamento da EIA é complexa e requer assim uma abordagem multidisciplinar, individualizada e integrada assente na evidência e recomendações científicas atuais, destacando-se as principais ao longo deste trabalho bem como algumas inovações em estudo.
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