Factors relating to curve progression in female patients with adolescent idiopathic scoliosis treated with a brace

Zhang, Yong; Yang, Yijun; Dang, Xiaoqian; Zhao, Li; Ren, Juan; Zhang, Ligen; Sun, Jianzhong

doi:10.1007/s00586-014-3674-3

Cited by 22 publications

(25 citation statements)

References 22 publications

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“…It is used to determine if an adolescent is under-weight (<5th percentile of sex and age-specific BMI), normal weight (5th to 85th percentile) or over-weight (>84th percentile). O’Neill et al (2005)79 found that over-weight AIS patients had 3.1 times more possibilities to fail in brace treatment than those not over-weighted. Progression over 45 ο happened in 45% of over-weight and 28% of normal.…”

Section: Resultsmentioning

confidence: 99%

<p>Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date</p>

Karavidas¹

2019

AHMT

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Brace effectiveness for adolescent idiopathic scoliosis was controversial until recent studies provided high quality of evidence that bracing can decrease likelihood of progression and need for operative treatment. Very low evidence exists regarding bracing over 40ο and adult degenerative scoliosis. Initial in-brace correction and compliance seem to be the most important predictive factors for successful treatment outcome. However, the amount of correction and adherence to wearing hours have not been established yet. Moderate evidence suggests that thoracic and double curves, and curves over 30ο at an early growth stage have more risk for failure. High and low body mass index scores are also associated with low successful rates. CAD/CAM braces have shown better initial correction and are more comfortable than conventional plaster cast braces. For a curve at high risk of progression, rigid and day-time braces are significantly more effective than soft or night-time braces. No safe conclusion on effectiveness can be drawn while comparing symmetrical and asymmetrical brace designs. The addition of physiotherapeutic scoliosis-specific exercises in brace treatment can provide better outcomes and is recommended, when possible. Despite the growing evidence for brace effectiveness, there is still an imperative need for future high methodological quality studies to be conducted.

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Section: Resultsmentioning

confidence: 99%

<p>Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date</p>

Karavidas¹

2019

AHMT

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“…Zhang et al [22] retrospectively studied the curve behavior of 89 braced AIS female patients. In his work, logistic regression analysis demonstrated that Risser score of less than 2 is one of the prognostic factors for curve progression by more than 5˚.…”

Section: Low Level Of Skeletal Maturitymentioning

confidence: 99%

“…Four articles identified rotation (apical rotation, rib hump and rib vertebral angle are all considered as rotation related) as a risk factor for curve progression [22,25−27]. In a sample of 89 patients, Zhang et al [22] described above noted that apical vertebral rotation beyond grade 3 is one of the risk factors for curve progression of more than 5˚. In another retrospective study [27], a comparison of patients having corrective surgery to patients defined with a nonprogressive curve was made in an attempt to identify three-dimensional parameters by an EOS system in a sample of 133 patients.…”

Section: Vertebral Rotationmentioning

confidence: 99%

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Hawary

Zaaroor-Regev²,

Floman

et al. 2019

The Spine Journal

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Brace treatment is the most common nonoperative treatment for the prevention of curve progression in adolescent idiopathic scoliosis. The success reported in level 1 and 2 clinical trials is approximately 75%. The aim of this review was to identify the main risk factors that significantly reduce success rate of brace treatment.A literature search using the MEDLINE and Embase databases was conducted. Studies were included if they identified specific risk factor(s) for curve progression. Studies that looked at nighttime braces, superiority of one type of brace over another, the effect of physical therapy on brace performance, cadaver or nonhuman studies were excluded. A total of 1,022 articles were identified of which 25 met all of the inclusion criteria. Seven risk factors were identified: Poor brace compliance (eight studies), lack of skeletal maturity (six studies), Cobb angle over a certain threshold (six studies), poor in-brace correction (three studies), vertebral rotation (four studies), osteopenia (two studies), and thoracic curve type (two studies). Three risk factors were highly repeated in the literature which identified specific subgroups of patients who have a much higher risk to fail brace treatment and to progress to fusion. This data demonstrates that 60% to 70% of the patients referred to bracing are Risser 0 and 30% to 70% of this group will not wear the brace enough to ensure treatment efficacy. Furthermore, Risser 0 patients who reach the accelerated growth phase with a curve ≥40˚are at 70% to 100% risk of curve progression to the fusion surgical threshold despite proper brace wear. Skeletally immature patients with relatively large magnitude scoliosis who are noncompliant FDA device/drug status: Not applicable.

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“…In this study we investigated the predictive value of BMD, in addition to other well-known risk factors, on curve progression to the surgical threshold (Cobb angle ≥ 45°). Previous prognostic studies mostly defined curve progression as Cobb angle increment ≥6° 916. Nevertheless, such increment of Cobb angle may not exert direct clinical significance, e.g., the treatment plan may not be affected even curve progress from 20° to 26°.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Bone Mineral Density on Curve Progression: A Longitudinal Cohort Study of 513 Girls with Adolescent Idiopathic Scoliosis

Yip

Wang

et al. 2016

Sci Rep

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Osteopenia has been found to occur in about 30% of Adolescent Idiopathic Scoliosis (AIS) patients. This study aimed to investigate its prognostic value on the risk of curve progression to surgical threshold. Newly diagnosed AIS girls (N = 513) with Cobb angle 10°–40° were recruited with follow-up till maturity. Bilateral hips were assessed with dual-energy x-ray absorptiometry (DXA). Distal radius of a subgroup of 90 subjects was further assessed with high-resolution peripheral quantitative computed tomography (HR-pQCT). 55 patients progressed to surgical threshold or underwent spine surgery at the end of follow-up. Cox model with osteopenia status performed significantly better than the model without (p = 0.010). Osteopenic patients had significantly higher risk of surgery (HR2.25, p = 0.011), even after adjustment for menarche status, age and initial Cobb angle. The incremental predictive value of osteopenia was, however, not statistically significant. In the subgroup analysis, cortical bone density was identified as a better marker to improve the sensitivity of the prediction, but requires further larger study to validate this finding. These consistent results of bone density measured at different sites suggest a systemic effect, rather than local effect to the deformed spine, and support to the link of abnormal bone density to the etiopathogenesis in AIS patients.

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Factors relating to curve progression in female patients with adolescent idiopathic scoliosis treated with a brace

Cited by 22 publications

References 22 publications

<p>Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date</p>

<p>Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date</p>

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review

Prognostic Value of Bone Mineral Density on Curve Progression: A Longitudinal Cohort Study of 513 Girls with Adolescent Idiopathic Scoliosis

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