Abstract
Methods A total of 1,238 individuals who were treated for JIS between 1995 and 2012 fulfilled the inclusion criteria (age between 4-10 years, full-time prescription), with 163 patients treated with progressive action short brace, Lyon brace and Milwaukee. Of these, 113 patients had a definite outcome, 27 abandoned treatment and 23 are still in treatment. The minimum duration of follow-up was 24 months. Antero-posterior radiographs were used to estimate the curve magnitude (CM) and the torsion of the apical vertebra (TA) at five points in time: beginning of treatment (t1), one year after the beginning of treatment (t2), intermediate time between t1 and t4 (t3), end of weaning (t4)and 2-year minimum follow-up from t4 (t5). Three outcomes were distinguished in agreement with Scoliosis Research Society criteria: curve correction, curve stabilization and curve progression. Moreover, results were evaluated according to compliance, dividing patients into five subgroups. Statistical analyses were performed with GraphPad Prism 6.
Highlights
Based on age of onset, severity and evolutivity, the purpose and use of conservative methods to treat juvenile idiopathic scoliosis (JIS) is a source of great debate
The results of our study showed that, of the 113 patients with a definite outcome, the curve magnitude (CM) mean value was 30.55 ± 5.16 SD at t1 and 21.9 ± 7.65 SD at t5
Curve correction was accomplished in 88 patients (77.8%), whereas a curve stabilization was obtained in 18 patients (15.9%)
Summary
Based on age of onset, severity and evolutivity, the purpose and use of conservative methods to treat juvenile idiopathic scoliosis (JIS) is a source of great debate. The different clinical experiences highlight difficulties in applying a conservative treatment to patients with JIS, characterized by inevitable evolutivity, who are effectively facing a long growing period. Treatment (t2), intermediate time between t1 and t4 (t3), end of weaning (t4)and 2-year minimum follow-up from t4 (t5). Three outcomes were distinguished in agreement with Scoliosis Research Society criteria: curve correction, curve stabilization and curve progression. Results were evaluated according to compliance, dividing patients into five subgroups. Statistical analyses were performed with GraphPad Prism 6.
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