Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria

Abstract

BackgroundThe efficacy of brace treatment for patients with adolescent idiopathic scoliosis (AIS) remains controversial. To make comparisons among studies more valid and reliable, the Scoliosis Research Society (SRS) has standardized criteria for brace studies in patients with AIS. The purpose of this study was to evaluate the efficacy of the Osaka Medical College (OMC) brace for AIS in accordance with the modified standardized criteria proposed by the SRS committee on bracing and non-operative management.MethodsFrom 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. Patients were instructed to wear the brace for a minimum of 20 hours per day at the beginning of brace treatment. The mean duration of brace treatment was 4 years and 8 months. We examined the initial brace correction rate and the clinical outcomes of main curves evaluated by curve progression and surgical rate, and the compliance evaluated by the instruction adherence rate for all cases. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria.ResultsThe average initial brace correction rate was 46.8%. In 10 cases the curve progressed, 6 cases the curve improved, and 15 cases the curve remained unchanged (success rate: 67.7%). The mean instruction adherence rate, that was defined the percentage of the visits that patients declared they mostly followed our instruction to total visits, was 53.7%. The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% (88.2%) as compared with in those 50% or less (42.8%).ConclusionsOMC brace treatment for AIS patients could alter the natural history and significantly decreased the progression of curves to the threshold for surgical intervention. Better instruction adherence of brace wear associated with greater success.

Impact of Rotation Correction after Brace Treatment on Prognosis in Adolescent Idiopathic Scoliosis

“…An armpit pad is for correction of the high thoracic curve by the righting reflex. OMC brace treatment for AIS could decrease the progression of curves and alter the natural history [56]. …”

Bracing Scoliosis - State of the Art (Mini-Review)

“…The increase for TLSO amounted to 39.3% [15] and 13.6% [16] in the two studies. The percentage increase when OMC weaned off was only 4.8% [17]. The symmetrical brace that achieved the best final corrective effects was the Lyon brace [13].…”

“…The loss of correction in asymmetrical braces was less than that of the symmetrical braces. After weaning of the thoracolumbosacral orthoses (TLSO) [15,16] and Osaka Medical College Brace (OMC) [17], the Cobb angle increased to higher than that of the pre-brace level. The increase for TLSO amounted to 39.3% [15] and 13.6% [16] in the two studies.…”

“…There are at present many different braces on the market. There are symmetrical [8,[12][13][14][15][16][17] and asymmetrical braces [18][19][20][21][22][23][24][25][26], rigid and soft braces [27], full time braces and nighttime braces. These braces have different biomechanical corrective principles, with varying effectiveness in halting progression of curvatures.…”

Brace Treatment for Children and Adolescents with Scoliosis

“…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].…”