The influence of Cheneau brace treatment compliance on the health-related quality of life and efficacy in adolescent idiopathic scoliosis

English Keywords:Adolescent idiopathic scoliosis  Cheneau brace  Compliance  Curve progression  Quality of life

English Abstract:

  【Abstract】 Objectives: To discuss the association between Cheneau brace treatment compliance and curve progression of high-risk adolescent idiopathic scoliosis(AIS). To compare the health-related quality of life in different compliant patients. Methods: 73 high-risk AIS patients who were treated with Cheneau brace from January 2007 to December 2012 were reviewed retrospectiovely． These patients had a mean age of 12.8±1.2 years, a mean main curve of 31.4°±6.0° and a mean Risser grade of 0.7±0.8 before bracing treatment. All patients were followed up at intervals of 3 to 6 months. Clinical and radiological results were assessed at each follow-up assessment. Standing radiographs with PA and lateral views were obtained. All patients were asked to answer a standardized health-related quality of life questionnaire at weaning. Curve progression was defined that Cobb angle greater than 6° compared with bracing initiation or aggravated to more than 45°(indicative for surgery). Compliance was defined as brace wear ≥22h daily until weaning. Patients were divided into two groups according to compliance. Group t-tests and Chi-square were performed to evaluate the influence of Cheneau brace treatment compliance on the health-related quality of life and curve progression. Results: The mean follow-up time was 1.8±0.8 years. 47(64%) patients were registered as compliance, while 26(36%) were non-compliant. The compliant group had a lower mean major curve Cobb angle than the non-compliant group(28.9°±11.7° vs 38.6°±11.6°, P<0.01). 8/47 compliers and 14/26 non-compliers had curve progression ≥6°（OR=5.7, 95%CI: 1.9-16.8）. SRS-22 scores regarding self-image, mental health and satisfaction for the brace treatment were significantly better in compliant patients(P<0.01). EuroQol scores were significantly lower in non-compliant patients(P<0.01). Conclusions: Good brace compliance reduces curve progression and improves the health-related quality of life in patients with high-risk AIS.