Does brace treatment impact upon the flexibility and the correctability of idiopathic scoliosis in adolescents?

Abstract

Purpose Brace treatment has served as a vital non-surgical procedure for immature adolescent idiopathic scoliosis (AIS) patients with a mild or moderate curve. For the patients who fail in bracing and resort to surgery, it is unclear whether prior full-time brace treatment significantly influences outcomes. This study aims to investigate whether prior brace treatment has a negative impact upon the flexibility and correctability of the main curve in patients with AIS. Methods The participants were collected from female AIS patients who underwent posterior correction surgery with pedicle screw instrumentation from August 2006 to December 2010, with or without prior brace treatment. Patients included in Group A had prior brace treatment over a 1-year period, and underwent surgery within 6 months after cessation of bracing; those in Group B received no prior treatment and were randomly selected from our database. Curve flexibility pre-surgery and curve correctability post-surgery were computed and compared between both groups and subgroups according to the curve location.Results Each group consisted of 35 patients. Age, curve magnitude and location were comparable between the two groups. Before surgery, patients in Group A had a slightly lower curve flexibility than those in Group B (52 vs. 60 %, P = 0.036). After surgery, satisfactory correction results were observed in both groups, but the average post-operative main curve magnitude of patients in Group B was 4°l ess than that of Group A (10°vs. 14°, P = 0.010). The curve correctability in Group B was significantly higher than that in Group A (80 vs. 74 %, P = 0.002). No matter what curve pattern the patient had, having a prior history of brace treatment resulted in a trend of lower flexibility and correctability of their scoliosis. Conclusions Good surgical correction can be achieved in AIS patients who have been unsuccessful with prior brace treatment. However, a history of prior brace treatment leads to a trend of lowering the curve flexibility, and in turn, negatively impacts upon the curve correctability.

Effect of SpineCor Dynamic Brace Treatment on the Result of Surgical Correction of Adolescent Idiopathic Scoliosis

“…Wang et al [9] indicate a small and insignificant decrease in the flexibility and correction of the primary curve after the surgical procedure in patients with a prior history of brace treatment compared to patients who had not been treated with a brace. History of preoperative brace treatment has not negative impact on postoperative self-perceived quality of life [9,3]. The presented study indicates that earlier treatment with a SpineCor dynamic brace does not have a significant effect on the amount of correction obtained through surgery.…”

“…The authors report satisfactory correction in both groups. However, they observe that a history of brace treatment has a negative impact on the correction of scoliosis, regardless of the type of curve, less visible in main thoracic curve [3]. Wang et al [9] indicate a small and insignificant decrease in the flexibility and correction of the primary curve after the surgical procedure in patients with a prior history of brace treatment compared to patients who had not been treated with a brace.…”

“…The standards involve: observation (mild curves), orthopedic supplies in the form of corrective braces (SRS standards: curve size between 25° and 40°, Risser sign between 0 and 2, and 10 years of age or older) [1,2], and surgical treatment for severe curve, greater than 40° if preventive treatment is unsuccessful [3,4]. An important procedure in preventive treatment, and the only one that is documented, is bracing, the aim of which is to reduce the risk of curve progression in order to avoid surgical procedure [3,5,6]. The SpineCor dynamic brace is a special type of orthopedic supply for a particular type of scoliosis, constituting a 20 hour therapy that supports the patient using a new corrective motion strategy and achieving integration on the skeletal-muscular-nervous level [6,7].…”

“…According Sun et al write that satisfactory correction of the curve can be achieved in patients who undergo surgery due to idiopathic scoliosis and have been earlier treated preventively with a brace. However, a history of brace treatment may have a negative effect on the final outcome of the surgery by reducing the flexibility of the curve, which results in poor correction [3]. There are no reports about the effect of using a SpineCor dynamic brace on the course of surgical treatment.…”

Rib-vertebral angle measurements predict brace treatment outcome in Risser grade 0 and premenarchal girls with adolescent idiopathic scoliosis

“…The current study confirmed the predictive value of RVAD and CRVA for the effectiveness of bracing in early AIS patients. Moreover, measurements of initial RVAD and CRVA before bracing can help to more accurately identify patients who are at higher risk of curve progression, thus to refine the indications and the protocols of brace treatment, because of the potential drawbacks of brace treatment, such as affecting the quality of life [31], reducing the flexibility of the spine [32], and so on. In addition, serial measurements of RVAD and CRVA provide constant assessments of the risk of curve progression, which are certainly more accurate and more reliable than that the measurements at brace initiation.…”