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Old 13th November 2005, 10:19 PM
gerbo gerbo is offline
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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
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Old 14th November 2005, 12:02 AM
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Sealy Sealy is offline
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The results are pretty much consistent with other studies - not spectacular results when you think about it :-? In terms of stopping progression it'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.
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