Loss of correction at short-term follow-up after bracing for patients with adolescent idiopathic scoliosis

English Keywords:Idiopathic scoliosis  Adolescent  Brace

English Abstract:

  【Abstract】 Objective：To investigate the loss of correction at short-term follow-up after bracing for patients with adolescent idiopathic scoliosis（AIS）.Method：Eighty-four AIS patients（4 males and 80 females），undergoing bracing according to standard treatment protocol from October 2002 to December 2007 and followed-up for short-term after bracing，were enrolled in this study.The mean age at initial admission was 12.8 years（range，from 10 to 15 years），the mean Risser sign was 1.6（range from 0 to 3） and the mean Cobb angle for major curve was 29.5°（range，from 20° to 43°）.36 patients had double major curve，22 had single thoracic curve and 26 had either single thoracolumbar or single lumbar curve.All patients took the standing long-cassette anteroposterior radiographs of spine at intervals of 3 to 6 months and 6 to 18 months after bracing.The curve type，chronologic age，Risser sign and menarcheal status were recorded respectively.Cobb angles were measured at initial admission and every timepoint of follow-up.The loss of correction was calculated and analyzed.Result：The average correction rate of bracing for AIS was 12.4％，14 patients（16.7％） were noted with curve progression.No significance difference of correction and curve progression rate was found between different curve patterns.The mean major Cobb angle at the end of bracing was 25.5°（range，10°-37°），which showed no significant difference compared with the final off-brace follow-up of 27.2°（P＞0.05），but significantly lower than the initial admission of 29.5°（P<0.05）.After brace treatment，15 patients（17.6％） were observed having curve progression.No significant difference was observed with regarding to the rate of curve progression between different curve patterns（P＞0.05）.Of all the patients with off-brace curve progression，the correction rate of major curve at bracing was 23.3％ and statistically higher than that with no off-brace curve progression（10.6％）.The curve magnitude during off-brace had no effect on the overall rate of curve progression.Conclusion：The curve progression of AIS can be effectively prevented in most AIS patients by bracing according to standard treatment protocol.Curve magnitude is stable at early stage after bracing. However，curve progression is still present in some patients，which is probably associated with more curve correction due to bracing rather than curve patterns and curve magnitude.