EFFECTIVENESS OF PATIENT-SPECIFIC THORACOLUMBAR BRACE TREATMENT FOR ADOLESCENT IDIOPATHIC SCOLIOSIS: A PROSPECTIVE COHORT STUDY

Özet

Objective: The efficacy of bracing for patients with adolescent idiopathic scoliosis (AIS) remains controversial. We aimed to evaluate the effectiveness of patient-specific thoracolumbar brace treatment in patients with AIS who met the Scoliosis Research Society inclusion criteria and the factors affecting success rate. Materials and Methods: From April 2015 to February 2018, 25 patients diagnosed with AIS treated with patient-specific thoracolumbar brace were asked to participate in this study. The initial brace correction rate and clinical outcomes of the main curvature was evaluated. The clinical course of bracing was considered progression if there was ≥6° curvature increase and improvement if there was ≥6° curvature decrease. The success rate was correlated with age, sex, Lenke classification, Risser grade, initial Cobb angle and rotation grade. Results: The curvature progressed and improved in 13 and two cases, respectively, and the curve remained unchanged in 10 cases. A success rate of 48% (12/25) was achieved. Moreover, only three of 25 cases with Cobb angle of 45° were considered candidates for surgery. The mean prebrace Cobb angle of the main curvature was 27.9°±6.7°, which ranged from 20° to 37°. The duration of bracing was 37.2 (6-76) months. The mean Cobb angle at the end of the treatment was 32.1°±8.2°, which ranged from 15° to 45°. No correlation was found between age, Risser grade and brace treatment success. However, treatment success was significantly correlated with initial Cobb angle, rotation grade and Lenke classification (main thoracic) (p<0.001, r=0.680; p=0.028, r=-0.458; p=0.020, r=0.481, respectively). Conclusion: Patient’s age, Risser grade and sex were not related with successful results of brace treatment. However, the initial Cobb angle, rotation of the apical vertebra and Lenke classification were significantly correlated with successful brace treatment.