Comparison of treatment for idiopathic scoliosis based on 2D radiographic analysis and the GOSS system

Abstract

Background information Conservative treatment of the spine has been used for many more years than surgical treatment, especially for the management of idiopathic scoliosis. In general, the biomechanical plan of the orthotic treatment is based mainly on 2-dimensional radiographic studies from which the Cobb angle, Risser sign, pelvic obliquity and vertebral rotation are obtained. This is true despite the 3-dimensional nature of scoliotic deformities. “Gomez Orthotic Spine Systems” (GOSS) is a method based on the treatment of the patient as a whole structure. Taking into consideration the alignment in all three body planes, beginning with the localization of the lines of greatest stability: coronal center line (CCL), sagittal central line (SCL) and transverse center line of rotation (TCL). All these lines will emerge from the base of support on the feet, allowing the clinician to understand and quantify the overall alignment and the capacity of the patient’s balance and stability. The GOSS method consists of an established protocol that evaluates the patient using photometry, followed by the analysis of the ideal corrective shape in three dimensions of each patient. Using the protocol in the correct order, the evaluation/fabrication of a custom asymmetrical TLSO can be accomplished.