Critical Review And Actuality Of Perdriolle'S Method In The Management Of Idiopathic Scoliosis

The aim of this study was to validate its actuality of Rene Perdriolle's study on the history of idiopathic thoracic and thoracolumbar scoliosis. By discussing his original work, the main parameters related to curve progression are presented, focusing on mechanical and developmental factors. In the original study, 221 patients affected by untreated thoracic and thoracolumbar scoliosis were followed from birth to adulthood. Indicators for monitoring curve progression were age, Tanner pubertal signs, Cobb's angle, torsion angle, and rotation specific angle. Three groups were identified: infantile scoliosis, juvenile-pubertal scoliosis, and pubertal scoliosis. Perdriolle's graphs are discussed analyzing their biomechanical aspect and comparing them with the graph of Duval-Beaupere. Curve patterns are defined in three stages, namely the non-progressive period, the main period of progression, and the second period of increase. Prognostic factors are detailed for each group. The alteration of vertebral body growth, modulated by the mechanical imbalance (divergent compression and tension forces), acts in curve evolution like a trigger, thus perpetuating the cycle to continue. Scoliosis progression mechanism is mostly related to biological and mechanical factors that are specific for each patient. The etiology of scoliosis appears less determinant. Despite many years being elapsed, the clinical implication stemmed from Perdriolle's original study is significant, as the understanding of the natural history of scoliosis allows a prospective elaboration useful for prognostic and therapeutic management.