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Spine Deform. 2016 May;4(3):200-205. doi: 10.1016/j.jspd.2015.12.002. Epub 2016 Apr 16.

Curve Progression in Adolescent Idiopathic Scoliosis With a Minimum of 2 Years' Follow-up After Completed Brace Weaning With Reference to the SRS Standardized Criteria.

Author information

1
Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
2
Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
3
Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
4
Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China. Electronic address: tplam@ort.cuhk.edu.hk.

Abstract

STUDY DESIGN:

A retrospective study.

OBJECTIVES:

To investigate curve evolution after brace weaning in adolescent idiopathic scoliosis (AIS) with reference to the Scoliosis Research Society (SRS) criteria.

SUMMARY OF BACKGROUND DATA:

Previous studies mainly focused on curve evolution during bracing in AIS. However, curve progression after brace weaning was not well addressed.

METHODS:

Braced AIS girls followed up for at least 2 years after brace weaning were reviewed. All patients had radiographs at initial visit, brace weaning, 6 months, 1 year, and 2 years after brace weaning, and last follow-up. Curve progression after brace weaning was separately defined as increase in Cobb angle >5 degrees and curve magnitude >45 degrees. The predictors for curve progression were identified using the independent t test.

RESULTS:

200 AIS girls were reviewed. The average duration of follow-up after brace weaning was 51.4 ± 25.6 months. Compared with brace weaning, at 6 months, 1 year, 2 years and last follow-up after brace weaning, 50 (25.0%), 60 (30.0%), 93 (46.5%), and 87 (43.5%) patients, respectively, had curve progression >5 degrees; 0 (0%), 0 (0%), 2 (1%), and 2 (1%) patients, respectively, had surgery recommended; among those with Cobb angle ≤40 degrees at brace weaning, 7 (4.0%), 11 (6.3%), 16 (9.2%), and 18 (10.3%) patients, respectively, had Cobb angle >45 degrees; the mean progression magnitudes were 2.6 ± 5.8, 3.5 ± 5.8, 5.1 ± 6.5, and 5.4 ± 7.4 degrees, respectively; and the mean progression rates were 0.34 ± 0.83, 0.16 ± 0.56, 0.13 ± 0.39, and 0.006 ± 0.28 degrees/month, respectively. Cobb angle at brace weaning was associated with increase in Cobb angle >5 degrees (p = .033) and curve magnitude >45 degrees (p < .001) after brace weaning.

CONCLUSIONS:

Curve progression after brace weaning is observed in 43.5% AIS patients. The highest risk occurs within 6 months after brace weaning whereas Cobb angle remains stable after 2 years' follow-up. High Cobb angle at brace weaning indicates high risk of curve progression after brace weaning.

LEVEL OF EVIDENCE:

Level III.

KEYWORDS:

Adolescent idiopathic scoliosis; Brace weaning; Curve progression; SRS

PMID:
27927503
DOI:
10.1016/j.jspd.2015.12.002
[Indexed for MEDLINE]

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