Brace Success Is Related to Curve Type in Patients with Adolescent Idiopathic Scoliosis

Thompson, Rachel; Hubbard, Elizabeth W.; Jo, Chan Hee; Virostek, Donald; Karol, Lori A.

doi:10.2106/jbjs.16.01050

Cited by 64 publications

(52 citation statements)

References 23 publications

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“…3). Four (4) level 2 prospective studies (published in six articles) contribute significantly to the results of our review [6,10,11,15,19,32]. These studies all used sensors to study brace wear compliance and investigated a very similar population: AIS patients in the United States with initial Cobb angle between 20˚and 40å nd who less than or equal to Risser 2.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant articles identified from the search are listed in Table 1 and more detailed description is available in the supplementary data section of this article. Although some of the risk factors were specific to only one article, seven risk factors were repeatedly mentioned in the literature: Poor brace compliance was mentioned as a major risk factor in eight studies [10,11,13−18], low values of skeletal maturity in six studies [9,19−23], Cobb angle over a certain value at the beginning of brace treatment in six studies [6,19,21−24], in-brace curve correction in three studies [9,18,25], significant vertebral rotation (apical vertebra rotation, Rib Hump, and Rib Vertebral Angle) in four studies [22,25−27], Osteopenia in two studies [21,28] and thoracic curve type in two studies [6,21]. These main risks are discussed in detail below.…”

Section: Identified Risk Factorsmentioning

confidence: 99%

“…Two articles identified thoracic curves to have a higher probability of progression than other curve types [6,21]. Thompson 39]).…”

Section: Curve Typementioning

confidence: 99%

“…et al[6] studied retrospectively a sample of 168Fig. 2.Rate of progression to surgery versus initial curve magnitude for each Risser sign.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Hawary

Zaaroor-Regev²,

Floman

et al. 2019

The Spine Journal

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Brace treatment is the most common nonoperative treatment for the prevention of curve progression in adolescent idiopathic scoliosis. The success reported in level 1 and 2 clinical trials is approximately 75%. The aim of this review was to identify the main risk factors that significantly reduce success rate of brace treatment.A literature search using the MEDLINE and Embase databases was conducted. Studies were included if they identified specific risk factor(s) for curve progression. Studies that looked at nighttime braces, superiority of one type of brace over another, the effect of physical therapy on brace performance, cadaver or nonhuman studies were excluded. A total of 1,022 articles were identified of which 25 met all of the inclusion criteria. Seven risk factors were identified: Poor brace compliance (eight studies), lack of skeletal maturity (six studies), Cobb angle over a certain threshold (six studies), poor in-brace correction (three studies), vertebral rotation (four studies), osteopenia (two studies), and thoracic curve type (two studies). Three risk factors were highly repeated in the literature which identified specific subgroups of patients who have a much higher risk to fail brace treatment and to progress to fusion. This data demonstrates that 60% to 70% of the patients referred to bracing are Risser 0 and 30% to 70% of this group will not wear the brace enough to ensure treatment efficacy. Furthermore, Risser 0 patients who reach the accelerated growth phase with a curve ≥40˚are at 70% to 100% risk of curve progression to the fusion surgical threshold despite proper brace wear. Skeletally immature patients with relatively large magnitude scoliosis who are noncompliant FDA device/drug status: Not applicable.

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Section: Discussionmentioning

confidence: 99%

Section: Identified Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Hawary

Zaaroor-Regev²,

Floman

et al. 2019

The Spine Journal

View full text Add to dashboard Cite

show abstract

“…The results of the search; (1) 31 items have been found of which 14 were found to be relevant reporting a rate of success [7,9,47,52,55,[62][63][64][65][66][67][68][69][70]; (2) 14 items were found of which 3 reported upon cosmetic outcomes [71][72][73]. In the hand search additional papers were revealed for search (1) [32- 46, 48-51, 53-55, 74].…”

Section: Resultsmentioning

confidence: 99%

Brace Treatment for Children and Adolescents with Scoliosis

Weiss¹,

Turnbull²

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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The aim of brace treatment in patients with scoliosis during growth is (1) to stop curve progression and (2) to improve appearance/cosmesis. There is high quality evidence available supporting brace treatment. According to recent publications, the outcomes of different braces vary to a high extent. Although most of the scoliosis cases will not affect the patient's health, the impact of braces on the cosmetic outcome to date is not well determined. Standardised asymmetric braces (mainly Chêneau derivatives) have better outcomes than symmetric compression braces and may also lead to significant improvements of the deformity. For symmetric braces, no evidence exists that these could significantly change the deformity. Soft braces have no indication and the use of night-time braces should be largely restricted due to poor outcomes when compared to current standards of full-time bracing.

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Quality, Safety, and Value Initiatives for Early-Onset Scoliosis

Vorhies

Frick

2022

The Growing Spine

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Brace Success Is Related to Curve Type in Patients with Adolescent Idiopathic Scoliosis

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 64 publications

References 23 publications

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Brace Treatment for Children and Adolescents with Scoliosis

Quality, Safety, and Value Initiatives for Early-Onset Scoliosis

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