RESUMO
Objective To guide bracing treatment for adolescent idiopathic scoliosis (AIS). Methods A total of 68 AIS patients with apex vertebrae (AV) under T6 had received the improved Cheneau bracing treatment between March 2008 and June 2010. All patients were divided into two groups. There were 16males and 35 females, with a mean age of 13.6 years (range, 10.6-17.2) in the intervention group. The mean Cobb angle was 29.5° (range, 20°-38°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the group;while there were 6 males and 11 females, with a mean of 13.2 years (range, 10.8-16.8) in the control group.The mean Cobb angle was 28.7° (range, 20°-37°); Risser sign was 2-4; Vertebralrotation degree was 0-2 in the control group. All patients in control group were informed standardized bracing treatment method. But we gave patients in intervention group two copies of "The Form of Guiding Bracing Treatment" treatment of patients with AIS, and informed that they carried out the bracing treatment according requirement of the form.Cobb angle was measured before the treatment and at 6th, 12th, 18th month after treatment. Results Sixtyfive cases were followed up for 18-27 months. However, one female in control group and two females in intervention group were lost during follow-up. Coefficient and intraclass correlation coefficient of form were both over 0.60. The acceptance rate of the table was 97.54%(199/204), qualified rate was 100.00%( 199/199), and with good content validity. The mean Cobb angle decreased gradually from 28.71° to 25.76° in control group and from 29.47° to 21.59° in intervention group. Four cases in control group and 34 cases in intervention group had reduced more than 5° at 18 months after treatment. There was significant difference regarding Cobb angle between two group. Conclusion The form of guiding bracing treatment has good reliability and validity and can guide bracing treatment of AIS correctly and effectively.
RESUMO
Objective To analyze the outcomes of bracing treatment for girls with adolescent idiopathic scoliosis (AIS), and to investigate the predictive factors of the protocol. Methods This study included 142 girls with AIS who finished standardized bracing treatment from July 2003 to July 2009. These patients had a mean age of 13.1±1.5 years, a mean main curve of 29.6°±5.4°, and a mean Risser grade of 2.0±1.5 before bracing treatment. Curve progression was defined that Cobb angle was greater than 6° compared to bracing initiation or was aggravated to more than 45° (indicative for surgery). The outcomes of bracing treatment were assessed based on the ratio of curves of progression or indicative for surgery. Chi-square and Logistic regression Analyses were performed to investigate the predictive factors of bracing treatment. Results The duration of bracing treatment averaged 2.5±1.0 years. Twenty-seven girls with curve progression (19%)and 115 girls (81%) with non-progression were found. Final curve which was greater than 45° was found in 18 girls (13%) who need a correction surgery, the remaining 124 girls (87%) had completed bracing treatment and avoided surgery. Chi-square analyses revealed that curve progression were more common in younger girls with lower Risser grade, with initial larger Cobb angle and with a main thoracic curve pattern.Logistic regression analyses found that premenarchal status and a main thoracic curve pattern were the independent risk factors of curve progression despite bracing. While initial Cobb angle which was greater than 30° was the additional independent risk factor of progression requiring surgery. Conclusion Bracing treatment could effectively prevent curve progression in most girls with AIS. The degree of growth maturity, the pattern and grade of curve are the influencing factor for bracing treatment.