Braces for idiopathic scoliosis in adolescents

Abstract

Due to the important clinical differences among the studies, it was not possible to perform a meta-analysis. Two studies showed that bracing did not change QoL during treatment (low quality), and QoL, back pain, and psychological and cosmetic issues in the long term (16 years) (very low quality). All included papers consistently showed that bracing prevented curve progression (secondary outcome). However, due to the strength of evidence (from low to very low quality), further research is very likely to have an impact on our confidence in the estimate of effect. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. This challenge may prevent us from seeing increases in the quality of the evidence over time. Other designs need to be implemented and included in future reviews, including 'expertise-based' trials, prospective controlled cohort studies, prospective studies conducted according to pre-defined criteria such as the Scoliosis Research Society (SRS) and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria. Future studies should increase their focus on participant outcomes, adverse effects, methods to increase compliance, and usefulness of physiotherapeutic scoliosis specific exercises added to bracing.

Adolescent idiopathic scoliosis and back pain

“…Numerous conservative techniques have been used to treat AIS, such as acupuncture, braces, electrical stimulation, exercises, foot orthosis, osteopathy, and yoga. The most recent systematic review on braces for AIS reported long-term stability in terms of back pain (very low quality evidence) in addition to a similar outcome for quality of life and psychological and cosmetic issues [ 39 ]. The authors highlighted that performing a meta-analysis was not possible due to differences among the studies.…”

Quasi-automatic early detection of progressive idiopathic scoliosis from biplanar radiography: a preliminary validation

“…Corrective surgery is invasive, and it is accompanied by non-negligible risks of complications. Bracing can be used to efficiently slow down or stop the progression, and patients often prefer it to observation [2,3]. Early detection of progressive curves offers the opportunity to undergo effective, non-operative treatments to the patients, thus reducing the need of surgery.…”

A Prospective Cohort Study of AIS Patients with 40° and More Treated with a Gensingen Brace (GBW): Preliminary Results

“…Treatment indications for scoliosis continue to be under debate [ 9 , 10 ]. Conservative treatment of scoliosis, both rehabilitative exercise and bracing, are recognized in literature reviews [ 11 - 14 ], Cochrane reviews [ 15 , 16 ] and randomized controlled studies [ 17 - 19 ]. Often, when a scoliosis reaches 45- 50º, surgery is the typical mode of treatment despite the absence of high-quality evidence [ 9 , 14 , 20 - 25 ].…”