The Effect of Shoe Lift on Lumbar Scoliosis Associated with Pelvic Obliquity

Abstract

Study design: A retrospective study designed to evaluate the effect of a shoe lift on the lumbar scoliosis associated with pelvic obliquity. Objectives: To analyze the changes in pelvic height, Cobb angle and clinical manifestations after application of a shoe lift. Summary of Literature Review: The most common form of scoliosis in adolescence is idiopathic (85% of scoliosis), which is a form of structural scoliosis. Some non-structural scoliosis may be assessed as an idiopathic form, which can result in an unnecessary treatment, such as bracing. Pelvic obliquity may be a cause of non-structural scoliosis, and a shoe lift may be used for its correction. Materials and Methods: Twelve cases of lumbar scoliosis associated with pelvic obliquity, between April, 1998 and October, 2002, were investigated for the changes in the pelvic height and Cobb angle. Standing T-L AP and standing pelvic AP for measuring the Cobb angle and pelvic obliquity, respectively, were checked before and after application of a shoe lift. The BellThompson method was used for measuring the limb length discrepancy. The shoe lift was composed of a compact cork pad and soft sponge tissue. The extent of a shoe lift was determined with the use of the most comfortable wood block height on standing still. The radiological and clinical outcomes of the shoe lift were investigated. Results: After the introduction of the shoe lift, 9 cases (75%) achieved a leveled pelvis (height difference less than 0.3cm) 1 week post-shoe lift. The mean Cobb angle before treatment was 16°, ranging from 9 to 26°, which was reduced to 6.7°, ranging from 0 to 23°, due to the shoe lift 1 week post-shoe lift. The mean correction of the Cobb angle after the introduction of a shoe lift was 73.9%. Clinically, 2 cases with low back pain achieved an improvement in the pain, and most patients expressed that walking and standing had become more comfortable. Conclusion: A shoe lift seems to be significantly effective in correcting the Cobb angle and pelvic height in lumbar scoliosis associated with pelvic obliquity.