Predictive Factors on Initial in-brace Correction in Idiopathic Scoliosis

Peeters, Charles M M; Hasselt, A.J. van; Wapstra, Frits-Hein; Jutte, Paulus Christiaan; Kempen, Diederik H.R.; Faber, Chris

doi:10.1097/brs.0000000000004305

Cited by 7 publications

(11 citation statements)

References 38 publications

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“…Although low evidence was found in the association of BMI and in-brace correction in a previous review study [20], this present study found a significant negative correlation between in-brace correction and BMI. Similarly, a study by Goodbody et al [14] concluded that overweight AIS patients had lower results in immediate brace correction as compared to the normal-weight group.…”

Section: Discussioncontrasting

confidence: 99%

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Evaluation of In-brace Correction in Individuals with Adolescent Idiopathic Scoliosis: A Retrospective and Descriptive Study

Putra

Limskul

Yotnuengnit

et al. 2022

Open Access Maced J Med Sci

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Introductions: Achieving maximum correction at the beginning of brace treatment in AIS is the only factor that can be controlled by the bracing provider if we have a better understanding of the prognostics and factors associated with achieving in-brace correction. The aim of this present study was to evaluate in-brace correction in a cohort of AIS patients who were treated by full-time bracing with plastic moulded thoraco-lumbo-sacral spinal orthosis (TLSO). Methods: This study was a retrospective descriptive study. We collected data from medical records of individuals with AIS who receiving full-time braces treatment from Orthotic Clinic, King Chulalongkorn Memorial Hospital. Demographic data included age, gender, weight, height, and body mass index (BMI). Cobb angle, Risser sign, and curve type were determined using pre and post-brace standing posteroanterior (PA) radiographs. Correlation analysis was performed to investigate in-brace correction with associated factors. Results: We included 91 patients' data and radiographic images with AIS, with seven (7.69%) boys and 84 (92.31%). The overall mean Cobb angle was 32.9 ± 8.5º, and during brace treatment, it was 22.5 ± 11.5º. There was a significant mean difference in the mean Cobb angle before and in-brace (p < 0.001). The overall mean in-brace correction in the study was 34.1 ± 22.7%. Initial Cobb angle and BMI were found to be significantly negatively associated with in-brace correction with a Pearson coefficient of -0.49 and -0.24, respectively. Conclusion: The mean of first in-brace correction TLSO was 34.1% from the initial Cobb angle. No difference in in-brace correction across curve types in our study. There was a significant Cobb angle changed before and in-brace radiograph. We found that in-brace correction was significantly associated with initial Cobb angle and BMI. Keywords: Adolescent Idiopathic Scoliosis, in-brace correction, bracing

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Section: Discussioncontrasting

confidence: 99%

“…A study by Lang et al found that in-brace correction was associated with initial Cobb angle, sagittal and coronal balance, and LPR [19]. In the current literature study, strong evidence was found between flexibility and in-brace correction and moderate evidence for curve pattern influencing in-brace correction [20].…”

Section: Discussionsupporting

confidence: 48%

Evaluation of In-brace Correction in Individuals with Adolescent Idiopathic Scoliosis: A Retrospective and Descriptive Study

Putra

Limskul

Yotnuengnit

et al. 2022

Open Access Maced J Med Sci

View full text Add to dashboard Cite

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“…Wong et al showed that in-brace correction offers relevant information about structural trunk plasticity [ 11 ]. Thus, a greater curve flexibility can lead to a better brace correction [ 12 ]. However, other spinal and pelvic variables beyond flexibility seem to influence the rate of in-brace correction [ 12 , 13 ], but their predictive role is not well-established.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, a greater curve flexibility can lead to a better brace correction [ 12 ]. However, other spinal and pelvic variables beyond flexibility seem to influence the rate of in-brace correction [ 12 , 13 ], but their predictive role is not well-established. A recent systematic review clarified the predictive value of various radiographical variables on brace outcome in AIS subjects, where reduced in-brace correction and <28% supine flexibility were confirmed to be predictors of progression with high and moderate evidence, respectively [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Clinically Meaningful Results of Bracing in a Large Cohort of Adolescents with Idiopathic Scoliosis Reaching the End of Conservative Treatment

et al. 2023

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Background: We need good outcome predictors to maximize the treatment efficiency of adolescents with idiopathic scoliosis (AIS). The in-brace correction has shown an important predictive effect on brace failure, while the influence of other variables is still debated. We aimed to identify new outcome predictors from a big prospective database of AIS. Methods: Design: Retrospective analysis of prospectively collected data. Inclusion criteria: AIS between 21 and 45°, Risser 0–2, brace prescription during the observation, treatment conclusion. All of the participants followed a personalized conservative approach according to the SOSORT Guidelines. Outcomes: End of growth below 30°–40°–50°. The regression model included age, BMI, Cobb angle, ATR, TRACE score, real brace wear (RBW), and in-brace correction (IBC). Results: A total of 1050 patients, 84% females, ages 12.1 ± 1.1, 28.2 ± 7.9° Cobb. IBC increased by 30%, 24%, and 23% the odds of ending treatment below 30°, 40°, and 50°, respectively. The OR did not change after the covariate adjustment. Cobb angle and ATR at the start also showed a predictive effect. Conclusions: The systematic evaluation of IBC in clinics is useful for individuating the patient response to brace treatment more accurately, even in relation to the Cobb angle and ATR degrees at the start. Further studies are needed to increase the knowledge on predictors of AIS treatment results.

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“…Curve type and curve flexibility are the best proven factors influencing this initial in-brace correction, but these patient factors cannot be influenced by the orthotist [ 5 ]. Translations generated by the brace on the thorax generally are statistically and linearly related to corresponding corrections of the spine, and a positive correlation has been reported between the correction of the lumbar scoliosis and correction of the lumbar lordosis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Are torso asymmetry and torso displacements in a computer brace model associated with initial in-brace correction in adolescent idiopathic scoliosis?

Peeters

Pijpker

Wapstra

et al. 2023

BMC Musculoskelet Disord

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Background Lack of initial in-brace correction is strongly predictive for brace treatment failure in adolescent idiopathic scoliosis (AIS) patients. Computer-aided design (CAD) technology could be useful in quantifying the trunk in 3D and brace characteristics in order to further investigate the effect of brace modifications on initial in-brace correction and subsequently long-term brace treatment success. The purpose of this pilot study was to identify parameters obtained from 3D surface scans which influence the initial in-brace correction (IBC) in a Boston brace in patients with AIS. Methods Twenty-five AIS patients receiving a CAD-based Boston brace were included in this pilot study consisting of 11 patients with Lenke classification type 1 and 14 with type 5 curves. The degree of torso asymmetry and segmental peak positive and negative torso displacements were analyzed with the use of patients’ 3D surface scans and brace models for potential correlations with IBC. Results The mean IBC of the major curve on AP view was 15.9% (SD = 9.1%) for the Lenke type 1 curves, and 20.1% (SD = 13.9%) for the type 5 curves. The degree of torso asymmetry was weakly correlated with patient’s pre-brace major curve Cobb angle and negligible correlated with major curve IBC. Mostly weak or negligible correlations were observed between IBC and the twelve segmental peak displacements for both Lenke type 1 and 5 curves. Conclusion Based on the results of this pilot study, the degree of torso asymmetry and segmental peak torso displacements in the brace model alone are not clearly associated with IBC.

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Predictive Factors on Initial in-brace Correction in Idiopathic Scoliosis

Cited by 7 publications

References 38 publications

Evaluation of In-brace Correction in Individuals with Adolescent Idiopathic Scoliosis: A Retrospective and Descriptive Study

Evaluation of In-brace Correction in Individuals with Adolescent Idiopathic Scoliosis: A Retrospective and Descriptive Study

Predictors of Clinically Meaningful Results of Bracing in a Large Cohort of Adolescents with Idiopathic Scoliosis Reaching the End of Conservative Treatment

Are torso asymmetry and torso displacements in a computer brace model associated with initial in-brace correction in adolescent idiopathic scoliosis?

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