Efficacy of bracing immediately after the end of growth: final results of a retrospective case series

Abstract

Methods In this retrospective study, the population included all AIS patients with Risser 4-5 at start that reached the end of treatment since our database started in 2003. We had 23 females and 2 males, average age of 16.5 ± 1.6 years, and an average Cobb angle measurement of 27.4° ± 8.4°. Patients received bracing treatment with Lyon or SPoRT braces for 18 to 24 hours per day, in addition to specific exercises, respecting SOSORT criteria, with a rapid weaning (2-3 hours every 6 months). Outcome criteria included the following parameters: SRS (unchanged; worsened over 6°; over 45° at the end of treatment; surgically treated; 2 years follow-up); clinical (ATR, hump, Aesthetic Index, plumbline distances); radiographic (Cobb degrees); and ISICO (optimum; minimum). ANOVA and chi-test were used for data analysis. Results The reported compliance during the 2.6 ± 0.6 treatment years was 95.1 ± 7.8%, while residual growth was 0.9 ± 1.1 cm. No patients progressed over 45°, no one was fused, and this remained true at the 2 years follow-up for the 25% that reached it. Improvements were found in 48% and 36% of worst and average curves, and in 45%, 58% and 36% of Thoracic, Thoracolumbar and Lumbar curves respectively. We found highly statistically significant reductions of maximal (-4.4°), average (-4.2°), thoracic (6.0°) and thoracolumbar (-6.6°) curves. Statistically significant improvements were found for Aesthetic Index, but not for ATR or plumbline distances. Clinically, 30% of patients improved over the measurement error for Aesthetic Index. According to ISICO criteria, 50% of patients had minimum and 35% optimal results.