Factors That Influence Outcome in Bracing Large Curves in Patients With Adolescent Idiopathic Scoliosis

Katz, Donald E.; Durrani, Abubakar Atiq

doi:10.1097/00007632-200111010-00012

Cited by 190 publications

(143 citation statements)

References 25 publications

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“…To answer the question of compliance, objective compliance measures using temperature sensor loggers and pressure transducers have been developed to ascertain compliance [24,33]. These authors used temperature data loggers at the brace-skin interface to measure time in the brace and found patients overestimated their time in brace nearly 150%.…”

Section: Bracing Difficultiesmentioning

confidence: 99%

Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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Skeletally immature patients with adolescent idiopathic scoliosis are at risk for curve progression. Although numerous nonoperative methods have been attempted, including physical therapy, exercise, massage, manipulation, and electrical stimulation, only bracing is effective in preventing curve progression and the subsequent need for surgery. Brace treatment is initiated as either full-time (TLSO, Boston) or nighttime (Charleston, Providence) wear, although patient compliance with either mode of bracing has been a documented problem. We review the natural history of adolescent idiopathic scoliosis, identify the risks for curve progression, describe the types of braces available for treatment, and review the indications for and efficacy of brace treatment.

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Section: Bracing Difficultiesmentioning

confidence: 99%

Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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“…An investigation into the factors that affect the outcome of brace treatment could help narrow the field of indications and provide further insight into whether brace treatment should be continued so as to avoid overtreatment or not. The prediction of the final outcome of brace treatment has been studied by many authors, and several risk factors for curve progression have been documented [6][7][8][9][10][11]. Lonstein and Winter [10] reviewed 1,020 patients treated with the Milwaukee brace, of whom 229 patients (22%) had to resort to surgery.…”

Section: Introductionmentioning

confidence: 99%

Potential genetic markers predicting the outcome of brace treatment in patients with adolescent idiopathic scoliosis

Qiu

Sun

et al. 2011

Eur Spine J

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Purpose To investigate whether the predisposition genes previously reported to be associated with the occurrence or curve severity of adolescent idiopathic scoliosis (AIS) play a role in the effectiveness of brace treatment. Method A total of 312 AIS patients treated with bracing were enrolled in this study. The Cobb angle of the main curve was recorded at the beginning of brace treatment as well as at each follow-up. The patients were divided into two groups according to the outcome of brace treatment (success/failure). The failure of brace treatment was defined as a curve progression of more than 5°compared to the initial Cobb angle or surgical intervention because of curve progression. Single nucleotide polymorphism (SNP) sites in the genes for estrogen receptor a (ERa), estrogen receptor b (ERb), tryptophan hydroxylase 1 (TPH-1), melatonin receptor 1B (MTNR1B) and matrillin-1 (MATN1), which were previously identified to be predisposition genes for AIS, were selected for genotyping by the PCR-RFLP method. Differences of genotype and allele distribution between the two groups were compared by the v 2 test. A logistic regression analysis was used to figure out the independent predictors of the outcome of brace treatment. Results There were 90 cases (28.8%) in the failure group and 222 cases (71.2%) in the success group. Patients in the failure group were associated with the genotype GA (50.9 vs. 17.9% p \ 0.001) and the G allele (27.1 vs. 12.0%, p \ 0.001) at SNP rs9340799 of the ERa gene. Similarly, they were also associated with the genotype AT (33.3 vs.13.0%, p = 0.002) and the A allele (16.7 vs. 9.6%, p = 0.033) at SNP rs10488682 of the TPH-1 gene. For MTNR1B, the difference of genotype distribution between the two groups was found to be statistically significant, while the difference of allele distribution between the two groups was found to be marginally statistically significant; for the MATN1 and ERb genes, we found no significant differences of the genotype or allele distribution between the two groups. In the logistic regression analysis, ERa and TPH-1 were demonstrated to be independent factors predictive of bracing effectiveness. Conclusions ERa and TPH-1 might be potential genetic markers that could predict the outcome of brace treatment. Patients with the G allele at the rs9340799 site of the ERa gene and the A allele at the rs10488682 site of the TPH-1 gene are prone to be resistant to brace treatment.

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“…However, the effectiveness of bracing is still controversial. Several studies have questioned the effectiveness of bracing in patients with adolescent idiopathic scoliosis [6,9,10]. Most of these were long-term follow-up studies assessing the effectiveness of bracing in terms of curve progression on radiographs; however, very few of them used lifestyle questionnaires as a method of assessment [3,7,16].…”

Section: Introductionmentioning

confidence: 99%

Outcome assessment of bracing in adolescent idiopathic scoliosis by the use of the SRS-22 questionnaire

Cheung

Cheng

Chan

et al. 2006

International Orthopaedics (SICO

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The SRS-22 questionnaire is specifically designed for the assessment of quality of life in spinal deformity patients. This study is the first to use it to assess the quality of life of adolescent idiopathic scoliosis patients under brace treatment and compares the results with an observational group matched by age and curve magnitude. Forty-six patients were enrolled into each group. Overall, it was found that patients under observation had a significantly better quality of life than braced patients. Specifically, the domains for function/activity and self-image were most affected. This effect was most apparent in those with a curve magnitude of under 20°. The scores did not improve significantly with the duration of brace wear, suggesting little adaptation. This study has implications for treatment, and more attention will need to be given to those with mild but progressive curves to help improve patients' understanding of their treatment and hence their compliance and satisfaction.Résumé Le questionnaire SRS-22 est spécifiquement dévolu à l'évaluation de la qualité de vie chez les patients présentant une déformation rachidienne. Cette étude est la première qui utilise l'information relative à la qualité de vie des adolescents présentant une scoliose idiopathique, traitée par plâtre, en comparant ces résultats avec un groupe identique sur le plan de l'âge et de l'importance de la déformation. Quarante-six patients ont été étudiés dans chaque groupe. Il est évident que les patients sous simple surveillance ont une qualité de vie bien supérieure à ceux traités par plâtre. De façon spécifique, ce sont surtout les critères d'activité et d'image de soi-même qui sont les plus affectés. Cet effet est surtout apparent chez les patients dont la courbe est inférieure à 20°. Les scores ne s'améliorent pas avec le temps, ce qui aurait pu suggérer une petite adaptation. Cette étude a des implications sur le traitement et une attention particulière doit être apportée à tous les patients présentant une courbe d'aggravation progressive de façon à améliorer leur compréhension du traitement et améliorer leur compréhension, leur compliance et leur satisfaction vis-à-vis du traitement.

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Factors That Influence Outcome in Bracing Large Curves in Patients With Adolescent Idiopathic Scoliosis

Cited by 190 publications

References 25 publications

Brace Management in Adolescent Idiopathic Scoliosis

Brace Management in Adolescent Idiopathic Scoliosis

Potential genetic markers predicting the outcome of brace treatment in patients with adolescent idiopathic scoliosis

Outcome assessment of bracing in adolescent idiopathic scoliosis by the use of the SRS-22 questionnaire

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