Good brace compliance reduced curve progression and surgical rates in patients with idiopathic scoliosis - PubMed (original) (raw)

Good brace compliance reduced curve progression and surgical rates in patients with idiopathic scoliosis

Jens Ivar Brox et al. Eur Spine J. 2012 Oct.

Abstract

Purpose: To examine the association between brace compliance and outcome.

Patients and methods: 495 (457 females) patients with late onset juvenile and adolescent idiopathic scoliosis were examined prospectively before bracing and at least 2 years after brace weaning. One spine surgeon examined all patients. 381 (353 females) answered a standardised questionnaire and 355 had radiological examination after median 24 years. Compliance was defined as brace wear >20 h daily until weaning. Main outcomes were curve progression and surgery.

Results: At weaning, 76/389 compliers and 59/106 non-compliers had curve progression ≥6° (OR 5.2, 95 % CI 3.3-8.2). At long-term the numbers were 68/284 and 46/71 (OR 5.8, 95 % CI 3.3-10.2), 10/284 versus 17/71 had been operated (OR 8.6, 95 % CI 3.7-19.9).

Conclusion: We conclude that the risk for curve progression and surgery are reduced in patients with good brace compliance.

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Figures

Fig. 1

Fig. 1

The percentages of patients with high compliance (3.5 %), irregular use (26 %), and aborted bracing (22 %) with surgery, and the percentages (24, 62, and 69 %) with curve progression ≥6°, respectively, at long-term follow-up, are shown

Fig. 2

Fig. 2

Development of the major scoliotic curve is shown in 328 patients with long-term radiological evaluation. Operated patients (n = 27) are not included. Mean Cobb angle ± 1 SD prebrace, at brace weaning, at 1- and 2-year, and at long-term follow-up are shown in 274 compliant patients and 54 non-compliant patients

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