Efficacy of nighttime brace in preventing progression of idiopathic scoliosis of less than 25°

Lateur, Gabriel; Grobost, Pierre; Julien, Gerbelot,; Eid, Ahmad; Griffet, J.; Courvoisier, Aurélien

doi:10.1016/j.otsr.2016.10.022

Cited by 11 publications

(13 citation statements)

References 17 publications

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“…Lauteur et al ( n = 142) studied the night-time brace concept. The treatment was successful in 83% of cases [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen non-comparative studies are represented in ( a ) and three comparative studies in ( b ). The grey color represents the rigid full-time concept, the red color the night-time concept, the green one the soft concept, and the orange color represents the control group [ 4 , 5 , 22 , 24 , 28 , 31 , 34 , 35 , 37 , 39 , 40 , 41 , 44 , 45 , 46 , 51 ].…”

Section: Figurementioning

confidence: 99%

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The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

Costa

Schlösser

Jimale

et al. 2021

JCM

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Brace treatment is the most common noninvasive treatment in adolescent idiopathic scoliosis (AIS); however it is currently not fully known whether there is a difference in effectiveness between brace types/concepts. All studies on brace treatment for AIS were searched for in PubMed and EMBASE up to January 2021. Articles that did not report on maturity of the study population were excluded. Critical appraisal was performed using the Methodological Index for Non-Randomized Studies tool (MINORS). Brace concepts were distinguished in prescribed wearing time and rigidity of the brace: full-time, part-time, and night-time, rigid braces and soft braces. In the meta-analysis, success was defined as ≤5° curve progression during follow-up. Of the 33 selected studies, 11 papers showed high risk of bias. The rigid full-time brace had on average a success rate of 73.2% (95% CI 61–86%), night-time of 78.7% (72–85%), soft braces of 62.4% (55–70%), observation only of 50% (44–56%). There was insufficient evidence on part-time wear for the meta-analysis. The majority of brace studies have significant risk of bias. No significant difference in outcome between the night-time or full-time concepts could be identified. Soft braces have a lower success rate compared to rigid braces. Bracing for scoliosis in Risser 0–2 and 0–3 stage of maturation appeared most effective.

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“…Lauteur et al ( n = 142) studied the night-time brace concept. The treatment was successful in 83% of cases [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

Costa

Schlösser

Jimale

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…[ 20 ] Boulot and Lateur recommend early treatment of AIS with nighttime bracing. [ 3 , 21 ] However, from our study, the earlier we treat with part-time bracing, the worse results we have, and our results are inferior to full-time brace wear for Risser stage 0–1 in MT and Risser stage 0 in ML. This result deserves caution since we tend to treat the more severe curves earlier.…”

Section: Discussionmentioning

confidence: 64%

Adolescent and Juvenile Idiopathic Scoliosis: Which Patients Obtain Good Results with 12 Hours of Cheneau–Toulouse–Munster Nighttime Bracing?

et al. 2022

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Background: The results of 12 h nighttime Cheneau–Toulouse–Munster (CTM) brace wear on adolescent idiopathic scoliosis are poorly described. Objective: The main objective was to analyze the efficiency of 12 h nighttime CTM brace wear on adolescent idiopathic scoliosis. The secondary objective was to identify the factors influencing good results. Methods: One hundred and fifty consecutive patients treated between 2006 and 2017 were retrospectively analyzed with subgroup analysis for the main curve pattern (main thoracic or main lumbar). The inclusion criteria were evolutive scoliosis, 12 h nighttime CTM brace wear, Risser stages 0-1-2 at the time of the prescription, and Cobb angle below 45 degrees. Success was defined as no surgery, and the main curve Cobb angle (CA) progression ≤5°. The overcurve was defined as the proximal thoracic curve above the main thoracic and mid-thoracic above the main lumbar curves. A logistic regression model was built to assess the predictors of success. RESULTS: Overall success was 70%: 60% for main thoracic (MT) and 84% for main lumbar scoliosis (ML) (p = 0.003). Efficacy was 62% at Risser stage 0 and 78% at Risser stage 1–2 (p = 0.054). For MT, failure was associated with high in-brace sagittal C7 tilt (Odds Ratio = 0.72, p = 0.014) and low initial overcurve CA (Odds Ratio = 0.42, p = 0.044). For ML, a high standing height was associated with success (OR = 1.42, p = 0.035), and frontal unbalanced C7 tilt was associated with failure (OR = 0.43, p = 0.02). Conclusion: Twelve-hour nighttime CTM brace wear provided good results for main lumbar curves with balanced frontal C7 tilt. For MT, this treatment is indicated if the in-brace sagittal C7 tilt is well balanced from Risser stage 2.

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“…Patients at our locale await several months following diagnosis to be reviewed by an orthopaedist, and as curve magnitude alone is an indicator for earlier appointments, those with mild yet progressive curves are attended to in a delayed manner. The effectiveness of bracing is well supported in mild curvatures of < 25° and therefore may be offered as a ‘prophylactic’ measure after appropriate counselling of at-risk individuals [26] . On the contrary, close observation may be recommended in confidence for non-progressive curves to avoid over prescription as bracing is a potential source of discomfort, skin irritation, and psychological distress.…”

Section: Discussionmentioning

confidence: 99%

Application of deep learning upon spinal radiographs to predict progression in adolescent idiopathic scoliosis at first clinic visit

et al. 2021

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Background: Prediction of curve progression risk in adolescent idiopathic scoliosis (AIS) remains elusive. Prior studies have revealed the potential for three-dimensional (3D) morphological parameters to prognosticate progression, but these require specialized biplanar imaging equipment and labor-intensive software reconstruction. This study aimed to formulate a deep learning model with standing posteroanterior (PA) X-rays at first clinic visit to differentiate between progressive (P) and non-progressive (NP) curves. Methods: For this retrospective cohort study, we identified patients presenting with AIS between October 2015 to April 2020 at our tertiary referral centre. Patients with mild curvatures (11 -30 o ) who were skeletally immature (Risser sign of ≤2) were recruited. Patients receiving biplanar X-ray radiographs (EOS™) were divided between a training-cross-validation cohort (328 patients) and independent testing cohort (110 patients). Another 52 patients receiving standard PA spinal X-rays were recruited for cross-platform validation. Following 3D reconstruction, we designated the major curve apex upon PA X-rays as the region of interest (ROI) for machine learning. A self-attentive capsule network was constructed to differentiate between curves manifesting P and NP trajectories. A two-stage transfer learning strategy was introduced to pre-train and fine-tune the model. Model performance (accuracy, sensitivity, specificity) was compared to that of traditional convolutional neural networks (CNNs) and a clinical parameter-based logistic regression model. Findings: 3D reconstruction identified that apical rotation of the major curve and torsion were significantly different between P and NP curve trajectories. Our predictive model utilizing an ROI centered on the major curve apex achieved an accuracy of 76.6%, a sensitivity of 75.2% and a specificity of 80.2% upon independent testing. Cross-platform performance upon standard standing PA X-rays yielded an accuracy of 77.1%, a sensitivity of 73.5% and a specificity of 81.0%. Errors in prediction occurred when the degree of apical rotation / torsion was discrepant from that of the subsequent curve trajectory but could be rectified by considering serial X-rays. Performance was superior to that of traditional CNNs as well as clinical parameter-based regression models. Interpretation: This is the first report of automated prediction of AIS curve progression based on radiomics and deep learning, towards directing treatment strategy at first visit. Patients predicted to be at-risk of progression may be counselled to receive early bracing with enforcement of treatment compliance. Over-treatment may be avoided in curves deemed to be non-progressive. Results need to be consolidated in larger sample populations of different ethnicities. Funding: The Society for the Relief of Disabled Children (SRDC).

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Efficacy of nighttime brace in preventing progression of idiopathic scoliosis of less than 25°

Abstract: Level IV, retrospective study.

Cited by 11 publications

References 17 publications

The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

Adolescent and Juvenile Idiopathic Scoliosis: Which Patients Obtain Good Results with 12 Hours of Cheneau–Toulouse–Munster Nighttime Bracing?

Application of deep learning upon spinal radiographs to predict progression in adolescent idiopathic scoliosis at first clinic visit

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