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gerbo
13th November 2005, 11:19 PM
Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up


Franz Landauer A1, Cornelius Wimmer A2, Hannes Behensky A2

A1 Department of Orthopaedic Surgery General Hospital Müllner Hauptstr. 48 A-5020 Salzburg Austria
A2 Department of Orthopaedic Surgery University of Innsbruck Austria


Abstract:


Objective: The study was conducted on the possibility of predicting the final outcome of bracing for idiopathic scoliosis at a follow-up period of 6 months. Methods: In a retrospective study, 62 adolescent female patients with right thoracic scoliosis (20-40° Cobb angle) treated with a brace were examined. A new compliance score was developed. The sample was divided into four groups based on compliance (compliance score) and initial correction (half-year after start bracing): group A, good compliance/high initial correction; group B, good compliance/low initial correction; group C, bad compliance/high initial correction; group D, bad compliance/low initial correction. The final outcome (1 year after weaning) was defined as successful if a curve correction of at least 5° was achieved. The influence of factors on final outcome was analysed by ANOVA. Differences between continuous data were analysed by a two-sample Wilcoxon test. Results: The overall final outcome was not successful (thoracic curve −3°). However, the average outcome of the compliant group was successful (−5°), while no success was achieved without good compliance (+5°). High initial correction of more than 40% (p < 0.002) and good compliance (p< 0.004) were of significant impact for the outcome. Patients showing good compliance and high initial correction presented a successful outcome of 7° Cobb angle. Conclusion: Compliant patients with a high initial correction can expect a final correction of around 7°, while compliant patients with low initial correction may maintain the curve extent. Bad compliance is always associated with curve progression.


Relevance of this study

(note;brace in this study was a Cheneau braced, a hard braced used on continent, possible similar to the Boston Brace

1) importance compliance but also high initial correction (>40%) for succes
2) compliant patient wearing their brace 23 hrs/day and with a >40% initial correction can expect a 7 degree improvement on the starting curve at the end of treatment

Sealy
14th November 2005, 01:02 AM
The results are pretty much consistent with other studies - not spectacular results when you think about it :-? In terms of stopping progression it&#39;s very good, unfortunately many teenage girls are not happy with their appearance and often stop wearing the brace and opt for surgery not knowing the full implications of their decision.