A report of two conservative approaches to early onset scoliosis: serial casting and bracing

Li, Ying; Swallow, Jennylee; Gagnier, Joel; Thompson, George H.; Sturm, Peter; Emans, John B.; Sponseller, Paul D.; Glotzbecker, Michael P.

doi:10.1007/s43390-020-00213-2

Cited by 1 publication

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“…The average follow-up was 3.2 (0.90-6.8) years. The average number of casts applied was 5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). At the most recent follow-up, 61 subjects were being treated with a brace, 3 with a cast, and 2 with growing rods.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies provide little evidence for the effectiveness of bracing in preventing curve progression, while more recent research suggests that bracing may have a comparable impact on curve progression compared with casting. 12,13 Radiographic outcomes are an essential measure of success in IEOS, but little is known about the effects of casting or bracing on health-related quality of life (HRQoL). Previous literature has suggested that casting negatively impacts HRQoL, but no study has directly compared the HRQoL effects of casting with bracing.…”

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confidence: 99%

“…Previous literature has suggested that casting negatively impacts HRQoL, but no study has directly compared the HRQoL effects of casting with bracing. 12,14 Therefore, the objectives of our study are to (1) assess HRQoL in a population of IEOS patients transitioning from casting to bracing during their course of treatment and (2) examine changes in major curve magnitude throughout treatment. We hypothesize that patients will experience an improvement in HRQoL as measured by the EOSQ-24 when transitioning from casting to bracing during treatment for IEOS.…”

mentioning

confidence: 99%

“…The evidence regarding the efficacy of bracing is conflicting. Previous studies provide little evidence for the effectiveness of bracing in preventing curve progression, while more recent research suggests that bracing may have a comparable impact on curve progression compared with casting 12,13. Radiographic outcomes are an essential measure of success in IEOS, but little is known about the effects of casting or bracing on health-related quality of life (HRQoL).…”

mentioning

confidence: 99%

“…Radiographic outcomes are an essential measure of success in IEOS, but little is known about the effects of casting or bracing on health-related quality of life (HRQoL). Previous literature has suggested that casting negatively impacts HRQoL, but no study has directly compared the HRQoL effects of casting with bracing 12,14…”

mentioning

confidence: 99%

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Does Transitioning to a Brace Improve HRQoL After Casting for Early Onset Scoliosis?

Henstenburg

Heard

Sturm

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Serial casting is favored for the initial treatment of early onset scoliosis (EOS), but there is concern about significant morbidity and caregiver burden. Studies have examined the utility of bracing as an alternative to casting, but little is known about differences in health-related quality of life (HRQoL) between treatments. We hypothesized that patients with a diagnosis of idiopathic EOS experience an improvement in HRQoL when transitioning from serial casting to bracing as measured by the 24-Item Early Onset Scoliosis Questionnaire (EOSQ). Methods: Subjects with idiopathic EOS were retrospectively identified from a multicenter database. EOSQ scores were compared before treatment, after index casting, after transition out of cast to brace, and at the most recent follow-up. Available major curve magnitudes were also compared during these time points. Data were compared using repeated-measures ANOVA with post hoc Bonferroni correction. Results: Sixty-six subjects met the inclusion criteria. Thirty-seven (56%) subjects were male and the average age at the time of index treatment was 1.9 (0.37-6.4) years. The average follow-up was 3.2 (0.90-6.8) years. In 57 subjects, the major curve magnitude improved from a mean of 33 (CI 28-37) degrees before treatment initiation to 27 (CI 23-30) degrees after casting and to 24 (CI 20-29) degrees at the most recent follow-up. The HRQoL subdomain showed a significant decrease in HRQoL during casting treatment 75.7 (CI 72.9-78.5) from pre-index treatment 84.9 (CI 81.4-88.5), during brace treatment 84.8 (CI 81.8-88.0) and at most recent follow-up 87.0 (CI 83.6-90.3) (P<0.001). The parental impact subdomain improved from the beginning to the end of treatment (77.7 to 87.7, P=0.001) (n=64). Satisfaction improved from casting to bracing (73.4 to 86.7, P<0.001) (n=63) and to the most recent follow-up (73.4 to 87.9, P<0.001). Conclusion: Patients treated with casting for EOS experience reversible declines in HRQoL. After patients transition from casting to bracing, EOSQ scores recover to pretreatment baseline levels and are maintained at follow-up. This information must be balanced with the effectiveness of treatment for EOS with either method and customized for each patient. Level of Evidence: Level III—retrospective comparative study.

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