Abstract
We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients’ perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group’s SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group’s results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had a bigger curve size after treatment and in this study than the other AIS patients.
Highlights
A number of studies have been conducted to investigate a long-term follow-up after surgical or conservative treatment for adolescent idiopathic scoliosis (AIS), concerning different types of brace treatment, among other subjects [1,2,3,4,5,6,7]
A study conducted by Climent et al concerning the impact of the type of brace on the health-related quality of life (HRQoL) of adolescents with spine deformities showed that the Cervico-Thoraco-Lumbosacral Orthosis (CTLSO) (e.g. Milwaukee brace) leads to a significantly greater impairment of the patient’s functioning during treatment than other types of orthoses [15,16]
In accordance with the criteria of the Scoliosis Research Society regarding the location of apex [32], thoracic scoliosis was identified in 21 patients (70%), thoracolumbar in 2 patients (6.67%) and lumbar curves were identified in 7 AIS females (23.33%)
Summary
A number of studies have been conducted to investigate a long-term follow-up after surgical or conservative treatment for adolescent idiopathic scoliosis (AIS), concerning different types of brace treatment, among other subjects [1,2,3,4,5,6,7]. Noonan et al [9] showed that, after reaching adulthood, there were no differences of a psychosocial nature in patients treated for AIS compared with healthy controls. It must be emphasized, most studies with long-term results regarding AIS refer to patients treated surgically [10,11,12,13]. Maruyama et al [14] adopted part-time wearing of the Milwaukee brace in order to maintain its effectiveness and at the same time to reduce the physical and psychological burden on the patients Their findings indicated that this was effective and did not affect the patients’ HRQoL [14]
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