title: [Experience with lateral electric surface stimulation in the treatment of progressive idiopathic scoliosis].
abstract: Due to incorrect use of nomenclature, scolioses are incorrectly classified in the paper by Altekruse and Heine. The angle measurement is inaccurate and does not correspond to Cobb's measuring method. The accuracy of the scientific statement and its value can be derived from this. The results of treatment obtained by Altekruse and Heine were improvement in or standstill of the scoliosis in 80% of the cases and progression in over 17%. This corresponds to the "Natural History of Scoliosis:" 5 to 25% of juvenile scolioses (age 3 to 10 years according to Drummont) are progressive, the figure for adolescent scolioses being lower. Therefore, electrostimulation is used to 70-80% in cases requiring no treatment, where there is no progression, in which there are no structural changes or which should be classified as malposture, in which spontaneous remission usually occurs or which remain stationary. In scolioses of over 25 degrees, with proven progression and structural changes, and possibly also with positive family history, electrostimulation fails. As in almost all papers published to date, Altekruse and Heine's paper disregards the behavior of the sagittal curvature of the spine under electrostimulation. We demonstrate in two cases that electrostimulation can have a considerable pathologic effect, causing lordosis. Since, on the basis of recently adopted opinions, there is reason to believe that there is a causal connection between lordosis and the pathogenesis of scoliosis, it must be assumed that in such cases electrostimulation incites or aggravates the development of scoliosis or is at least potentially capable of doing so. At any rate, in the two cases in which it was demonstrated that electrostimulation caused lordosis, the scoliosis was significantly aggravated, so that in these cases at least it must be assumed that the method has a health-damaging effect. Electrostimulation is a cost factor which does not seem justifiable today, with economy an obligation. The cost of using it in a mere 100 cases would be sufficient to pay for proper screening of all the children in one school year in the Federal Republic. Children who are really at risk could be given effective treatment. In Sweden, this has resulted in 60% of the scoliosis operations previously required in populations of the same size no longer being necessary.
mesh_terms: D000293:Adolescent; D002648:Child; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005260:Female; D006128:Growth; D006801:Humans; D008141:Lordosis / Q000209:etiology; D009119:Muscle Contraction; D011187:Posture; D011859:Radiography / Q000009:adverse effects; D012107:Research Design / Q000592:standards; D012306:Risk; D012600:Scoliosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013131:Spine / Q000000981:diagnostic imaging / Q000503:physiopathology; D009626:Terminology as Topic
vernacular_title: Erfahrungen mit der lateralen elektrischen Oberflächenstimulation bei der Behandlung der progredienten idiopathischen Skoliose.