During growth, idiopathic scoliosis tends to progress in a high percentage of cases. The progression rate varies according to the age at diagnosis, with infantile scoliosis being the most unpredictable. There are many confounders, such as age, Risser sign and baseline Cobb angles that were not consistent among studies, making the data very heterogeneous.

BackgroundA temperature monitor is used to objectively measure brace wear time in adolescent idiopathic scoliosis. The reliability of this device have been demonstrated, and some specialists introduced the use of a compliance monitor as a standard of care in everyday clinical practice, as we did since 2010 with the Thermobrace (TB). The attitude towards these objective monitors has never been investigated.The present study aims to investigate the attitude of parents and patients towards the use of temperature sensors for measuring brace wear compliance.MethodsThree hundred one consecutive girls and 63 boys and their parents have been interviewed. The inclusion criteria were as follows: brace wear full-time prescription at first visit and at least one visit with download and discussion of TB data.Usefulness, acceptability, reliability, and feeling related to data download were the investigated domains. Patients were invited by the administrative staff to complete anonymously the questionnaire. The European Commission was informed about the present survey and approved it (ICT-37-2015-1). Descriptive statistic was used to present the results.ResultsAmong the 364 invited patients and parents, 336 adhered by completing it (rate of responders was 93.2%). The mean age was 14.65 (SD 2.36), the mean Cobb angle was 34.18 (SD 13.57), and the average brace wear prescription was 21.76 h per day (SD 2.53). We did not ask parents about their age, profession, nor other personal data.Globally, the interviewed patients and parents showed a very positive attitude towards the TB monitor: the mean rate of parents stating a completely or at least partially positive attitude towards this electronic device was 94.0% while among patients, it was 85.6%.ConclusionsThis is the first study investigating the attitude of parents and patients towards a brace wear compliance monitor. People who experienced this objective monitoring are aware of the advantages related to it and support its usefulness not only for clinicians but also for patients and parents to respect the hours prescribed without any affection on the children and parents or the patient-physician relationship. The present results should encourage the spread of these tools in daily clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s13013-017-0119-x) contains supplementary material, which is available to authorized users.

Purpose In-brace radiograph of adolescents with idiopathic scoliosis (AIS) has been shown to reflect brace efficacy and the possibility of achieving curve correction. Conversely, the first out-of-brace radiograph could demonstrate the patient’s ability to maintain the correction. We aimed to determine which of the two radiographs is the best predictor of the Cobb angle at the end of treatment (final radiograph). Design Retrospective cohort study of a prospective dataset. Methods The population was selected based on the following inclusion criteria: AIS, age 10–18 years; Risser score 0–2; Cobb angle 25–40°; brace treatment; availability of all radiographs. Statistics: Pearson correlations provide a first exploration of data. The univariate and multivariate logistic regression model tested the predictors. Finally ROC curve provided a check of model accuracy. Results A total of 131 patients were included (mean age 13.0 ± 1.3, Cobb angle 33.2 ± 5.5°; 78% females). At the end of treatment, 56% had stabilised, 9% had progressed, and 44% had improved. The difference between the in-brace and final radiographs was 8.0 ± 6.0°, while the difference between the first out-of-brace and final radiographs was 1.8 ± 5.2°. The best predictor of final outcome was the first out-of-brace radiograph (0.80), compared to in-brace (0.68) and baseline (0.59) radiographs. The best cut-offs to predict avoidance of progression were 30% and 10% of the correction rates for the in-brace and first out-of-brace radiographs, respectively. Conclusion The first out-of-brace radiograph predicts end results better than the in-brace radiograph. It offers an excellent clinical reference for clinicians and patients. The first out-of-brace radiograph should be considered an essential element of future predictive models. Level of Evidence 1 Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

IntroductionRecently the EOS imaging system (EOS Imaging, Paris, France) has provided advancements in 3D spinal modeling. Advancements include low radiation as well as fast and accurate reconstructed measurements of spinal parameters. There is a paucity of studies analyzing the reproducibility of the EOS Imaging System and the sterEOS software in the production of 3D spinal models for children with adolescent idiopathic scoliosis (AIS). Objectives The purposes of the study were 1) to determine the intraclass correlation (ICC) for both the inter-observer and intra-observer in the measurements of Cobb angles in AP view as well as the Cobb angles in the lateral view; 2) to assess the ICC for inter-and intra-observer in the axial vertebral rotation (AVR) of the apex vertebra; 3) to compare differences of spinal parameters between two examiners and two trials; 4) to determine how long a 3D reconstruction of the spine takes. Methods Bilateral x-ray images of fifteen patients (age: 6 -15 years old, 5 males, 10 females) were retrospectively selected. These EOS images were uploaded into the sterEOS computer program. Within the software, spinal and pelvic parameters were identified manually to construct a 3D model of the spine. The sterEOS software calculates the Cobb angles, angles of lordosis, angles of kyphosis, and the AVRs of the apex vertebra. The 3D modeling was performed independently by two examiners. Each examiner modeled each patient's spine in two spaced out trials. The ICC between inter-and intra-observers were calculated and compared statistically. Results and discussionBoth the inter-and intra-observers showed excellent reproducibility for the Cobb angles in the proximal segment (ICC: 0.72 -0.91), kyphosis (ICC: 0.85-0.92), and lordosis (ICC: 0.82 -0.95). No significant differences were found between angle differences (0.35°to 2.4°). In contrast to the traditional radiography, the sterEOS provides a better high quality view within the sagittal plane. A moderate inter-observer ICC for the Cobb angle in the distal segment (ICC = 0.67) indicates the examiners have to carefully adjust the alignment and vertebrae in 3D rather than in 2D following the automatic computation from the EOS software. The interobserver ICC for the AVR in the lumbar region (0.80) is higher than the thoracic or thoracolumbar region (0.65), but with high differences of AVR (4.0°-6.3°). The average time that two examiners spent per subject ranged from 34.6 to 37.4 minutes. Conclusion and significance EOS provides significantly reliable and accurate spinal modeling in the measurement of children with AIS. Exposure to less radiation as compared to other radiographic modality allows EOS to offer acceptable quality view of the spine in the sagittal and transversal plane. sagittal balance and predictive equations to determine lumbopelvic compensatory patterns (LPCP). These equations are used to guide surgical decision making and technique selection. Although other lumbopelvic compensation equations are available, these have not been compared wi...

Despite the rarity of the condition and despite the rarity of vertebral body lesion resolution, total vertebral body reconstruction was observed over a 7-year period. Long-term follow-up is necessary for a better understanding of the final outcome of patients with EG.

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Purpose Some teenagers with adolescent idiopathic scoliosis (AIS) display compromised lung function. However, the evidence regarding the relations between pulmonary impairments and various spinal deformity parameters in these patients remains unclear, which affects clinical management. This systematic review and meta-analysis aimed to summarize the associations between various lung function parameters and radiographic features in teenagers with AIS. Methods A search of PubMed, Embase, PEDro, SPORTDiscus, CINAHL, Cochrane Library, and PsycINFO (from inception to March 14, 2022) without language restriction. Original studies reporting the associations between lung function and spinal deformity in patients with AIS were selected. Independent reviewers extracted data and evaluated the methodological quality of the included studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pearson correlation and 95% confidence intervals were calculated using random-effects meta-analysis. Results Twenty-seven studies involving 3162 participants were included. Limited-quality evidence supported that several spinal parameters were significantly related to lung function parameters (e.g., absolute value and percent of the predicted forced vital capacity (FVC; %FVC), forced expiratory volume in one second (FEV1; %FEV1), and total lung capacity (TLC; %TLC)) in AIS patients. Specifically, meta-analyses showed that main thoracic Cobb angles in the coronal plane were significantly and negatively related to FVC (r =  − 0.245), %FVC (r =  − 0.302), FEV1 (r =  − 0.232), %FEV1 (r =  − 0.348), FEV1/FVC ratio (r =  − 0.166), TLC (r =  − 0.302), %TLC (r =  − 0.183), and percent predicted vital capacity (r =  − 0.272) (p < 0.001). Similarly, thoracic apical vertebral rotation was negatively associated with %FVC (r =  − 0.215) and %TLC (r =  − 0.126) (p < 0.05). Conversely, thoracic kyphosis angles were positively related to %FVC (r = 0.180) and %FEV1 (r = 0.193) (p < 0.05). Conclusion Larger thoracic Cobb angles, greater apical vertebral rotation angle, or hypokyphosis were significantly associated with greater pulmonary impairments in patients with AIS, although the evidence was limited. From a clinical perspective, the results highlight the importance of minimizing the three-dimensional spinal deformity in preserving lung function in these patients. More research is warranted to confirm these results.

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