Predictors of Clinically Meaningful Results of Bracing in a Large Cohort of Adolescents with Idiopathic Scoliosis Reaching the End of Conservative Treatment.
adolescent idiopathic scoliosis
brace
outcome predictors
Journal
Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936
Informations de publication
Date de publication:
13 Apr 2023
13 Apr 2023
Historique:
received:
18
12
2022
revised:
17
03
2023
accepted:
10
04
2023
medline:
16
5
2023
pubmed:
16
5
2023
entrez:
16
5
2023
Statut:
epublish
Résumé
We need good outcome predictors to maximize the treatment efficiency of adolescents with idiopathic scoliosis (AIS). The in-brace correction has shown an important predictive effect on brace failure, while the influence of other variables is still debated. We aimed to identify new outcome predictors from a big prospective database of AIS. Design: Retrospective analysis of prospectively collected data. AIS between 21 and 45°, Risser 0-2, brace prescription during the observation, treatment conclusion. All of the participants followed a personalized conservative approach according to the SOSORT Guidelines. End of growth below 30°-40°-50°. The regression model included age, BMI, Cobb angle, ATR, TRACE score, real brace wear (RBW), and in-brace correction (IBC). A total of 1050 patients, 84% females, ages 12.1 ± 1.1, 28.2 ± 7.9° Cobb. IBC increased by 30%, 24%, and 23% the odds of ending treatment below 30°, 40°, and 50°, respectively. The OR did not change after the covariate adjustment. Cobb angle and ATR at the start also showed a predictive effect. The systematic evaluation of IBC in clinics is useful for individuating the patient response to brace treatment more accurately, even in relation to the Cobb angle and ATR degrees at the start. Further studies are needed to increase the knowledge on predictors of AIS treatment results.
Sections du résumé
BACKGROUND
BACKGROUND
We need good outcome predictors to maximize the treatment efficiency of adolescents with idiopathic scoliosis (AIS). The in-brace correction has shown an important predictive effect on brace failure, while the influence of other variables is still debated. We aimed to identify new outcome predictors from a big prospective database of AIS.
METHODS
METHODS
Design: Retrospective analysis of prospectively collected data.
INCLUSION CRITERIA
METHODS
AIS between 21 and 45°, Risser 0-2, brace prescription during the observation, treatment conclusion. All of the participants followed a personalized conservative approach according to the SOSORT Guidelines.
OUTCOMES
RESULTS
End of growth below 30°-40°-50°. The regression model included age, BMI, Cobb angle, ATR, TRACE score, real brace wear (RBW), and in-brace correction (IBC).
RESULTS
RESULTS
A total of 1050 patients, 84% females, ages 12.1 ± 1.1, 28.2 ± 7.9° Cobb. IBC increased by 30%, 24%, and 23% the odds of ending treatment below 30°, 40°, and 50°, respectively. The OR did not change after the covariate adjustment. Cobb angle and ATR at the start also showed a predictive effect.
CONCLUSIONS
CONCLUSIONS
The systematic evaluation of IBC in clinics is useful for individuating the patient response to brace treatment more accurately, even in relation to the Cobb angle and ATR degrees at the start. Further studies are needed to increase the knowledge on predictors of AIS treatment results.
Identifiants
pubmed: 37189968
pii: children10040719
doi: 10.3390/children10040719
pmc: PMC10136690
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Clin Orthop Relat Res. 2020 Feb;478(2):334-345
pubmed: 31688210
Eur Spine J. 2019 Mar;28(3):511-525
pubmed: 30607519
N Engl J Med. 2013 Oct 17;369(16):1512-21
pubmed: 24047455
J Bone Joint Surg Am. 2021 Jan 6;103(1):37-43
pubmed: 33065593
World Neurosurg. 2019 Mar;123:e597-e603
pubmed: 30529518
Spine (Phila Pa 1976). 2016 Nov 15;41(22):1724-1730
pubmed: 27076435
Eur Spine J. 2016 Feb;25(2):500-5
pubmed: 25906378
Scoliosis. 2015 Feb 05;10:3
pubmed: 25729406
Ann Phys Rehabil Med. 2020 May;63(3):216-221
pubmed: 31816447
Clin Spine Surg. 2017 May;30(4):E475-E479
pubmed: 28437355
J Child Orthop. 2013 Feb;7(1):3-9
pubmed: 24432052
Spine Deform. 2019 Nov;7(6):890-898.e4
pubmed: 31731999
Spine (Phila Pa 1976). 1986 Oct;11(8):780-3
pubmed: 3810292
Spine (Phila Pa 1976). 2001 Nov 1;26(21):2354-61
pubmed: 11679821
J Bone Joint Surg Am. 2016 Jan 6;98(1):9-14
pubmed: 26738898
Bone Joint J. 2020 Feb;102-B(2):254-260
pubmed: 32009436
Spine (Phila Pa 1976). 2020 Sep 1;45(17):1193-1199
pubmed: 32205704
Scoliosis. 2012 May 31;7(1):12
pubmed: 22651570
BMC Musculoskelet Disord. 2019 Aug 22;20(1):384
pubmed: 31438927
Eur J Phys Rehabil Med. 2014 Oct;50(5):479-87
pubmed: 25251736
J Bone Joint Surg Am. 2014 Apr 16;96(8):649-53
pubmed: 24740661
Scoliosis Spinal Disord. 2017 Oct 30;12:36
pubmed: 29094108
Eur Spine J. 2012 Oct;21(10):2050-8
pubmed: 22732829
Scoliosis Spinal Disord. 2018 Jan 10;13:3
pubmed: 29435499
World J Orthop. 2015 Aug 18;6(7):537-58
pubmed: 26301183
J Clin Med. 2021 Oct 28;10(21):
pubmed: 34768544
Spine Deform. 2015 Sep;3(5):436-439
pubmed: 27927529
Pol Orthop Traumatol. 2014 Jul 28;79:118-22
pubmed: 25066033
J Bone Joint Surg Am. 2015 Feb 18;97(4):344-50
pubmed: 25695990
J Bone Joint Surg Am. 2008 Mar;90(3):540-53
pubmed: 18310704
Eur Spine J. 2015 Feb;24(2):244-8
pubmed: 25424687
Scoliosis. 2011 May 09;6:8
pubmed: 21554719
Eur J Phys Rehabil Med. 2021 Feb;57(1):101-109
pubmed: 33016064
Eur Spine J. 2021 Jul;30(7):1813-1822
pubmed: 33772381
Spine (Phila Pa 1976). 2022 Apr 15;47(8):E353-E361
pubmed: 35500086
Spine (Phila Pa 1976). 2001 Sep 15;26(18):2001-5
pubmed: 11547200
Cochrane Database Syst Rev. 2015 Jun 18;(6):CD006850
pubmed: 26086959
Eur Spine J. 2016 Oct;25(10):3088-3094
pubmed: 26803296
Spine Deform. 2020 Dec;8(6):1213-1222
pubmed: 32696447
Bone Joint J. 2022 Apr;104-B(4):424-432
pubmed: 35360948