Abstract
To examine the association between brace compliance and outcome. 495 (457 females) patients with late onset juvenile and adolescent idiopathic scoliosis were examined prospectively before bracing and at least 2years after brace weaning. One spine surgeon examined all patients. 381 (353 females) answered a standardised questionnaire and 355 had radiological examination after median 24years. Compliance was defined as brace wear >20h daily until weaning. Main outcomes were curve progression and surgery. At weaning, 76/389 compliers and 59/106 non-compliers had curve progression ≥6° (OR 5.2, 95% CI 3.3-8.2). At long-term the numbers were 68/284 and 46/71 (OR 5.8, 95% CI 3.3-10.2), 10/284 versus 17/71 had been operated (OR 8.6, 95% CI 3.7-19.9). We conclude that the risk for curve progression and surgery are reduced in patients with good brace compliance.
Highlights
Idiopathic scoliosis is a structural lateral and rotary curvature of the spine in an otherwise normal child
Long-term follow-ups indicate that health-related quality of life (HRQL), including pain, disability, work, and the number of children born in patients with curves ranging from 20° to 50°, are comparable in patients with idiopathic scoliosis and the normal population [3, 10, 11]
The main finding in the present study is that the compliers had less curve progression and lower risk for surgery than non-compliers
Summary
Idiopathic scoliosis is a structural lateral and rotary curvature of the spine in an otherwise normal child. It is reported that 0.3–0.5 % of children younger than 16 years of age have a curvature [20° [21]. We reported that the point prevalence in 12-year-old children is 0.13 % [2]. Long-term follow-ups indicate that health-related quality of life (HRQL), including pain, disability, work, and the number of children born in patients with curves ranging from 20° to 50°, are comparable in patients with idiopathic scoliosis and the normal population [3, 10, 11]. A recently published meta-analysis including mainly longitudinal cohort studies, reported that the percentage of brace-treated patients with later surgery ranges from 1 to 43 % as compared with 13 to 28 % after observation [5]. The meta-analysis has methodological limitations including poor documentation of compliance of brace wear and varying indications for surgery
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