Landauer Franz, Wimmer Cornelius, Behensky Hannes
Department of Orthopaedic Surgery, General Hospital, Salzburg, Austria.
Pediatr Rehabil. 2003 Jul-Dec;6(3-4):201-7. doi: 10.1080/13638490310001636817.
The study was conducted on the possibility of predicting the final outcome of bracing for idiopathic scoliosis at a follow-up period of 6 months.
In a retrospective study, 62 adolescent female patients with right thoracic scoliosis (20-40 degrees Cobb angle) treated with a brace were examined. A new compliance score was developed. The sample was divided into four groups based on compliance (compliance score) and initial correction (half-year after start bracing): group A, good compliance/high initial correction; group B, good compliance/low initial correction; group C, bad compliance/high initial correction; group D, bad compliance/low initial correction. The final outcome (1 year after weaning) was defined as successful if a curve correction of at least 5 degrees was achieved. The influence of factors on final outcome was analysed by ANOVA. Differences between continuous data were analysed by a two-sample Wilcoxon test.
The overall final outcome was not successful (thoracic curve -3 degrees). However, the average outcome of the compliant group was successful (-5 degrees), while no success was achieved without good compliance (+5 degrees). High initial correction of more than 40% (p < 0.002) and good compliance (p< 0.004) were of significant impact for the outcome. Patients showing good compliance and high initial correction presented a successful outcome of 7 degrees Cobb angle.
Compliant patients with a high initial correction can expect a final correction of around 7 degrees, while compliant patients with low initial correction may maintain the curve extent. Bad compliance is always associated with curve progression.
本研究旨在探讨在6个月的随访期内预测特发性脊柱侧凸支具治疗最终结果的可能性。
在一项回顾性研究中,对62例接受支具治疗的右胸弯青少年女性患者(Cobb角20 - 40度)进行了检查。制定了一个新的依从性评分。根据依从性(依从性评分)和初始矫正情况(开始支具治疗半年后)将样本分为四组:A组,依从性好/初始矫正高;B组,依从性好/初始矫正低;C组,依从性差/初始矫正高;D组,依从性差/初始矫正低。如果侧弯矫正至少达到5度,则将最终结果(停止支具治疗1年后)定义为成功。采用方差分析分析各因素对最终结果的影响。连续数据之间的差异采用两样本Wilcoxon检验进行分析。
总体最终结果未成功(胸弯-3度)。然而,依从组的平均结果是成功的(-5度),而依从性不好的组未取得成功(+5度)。初始矫正超过40%(p < 0.002)和依从性好(p < 0.004)对结果有显著影响。依从性好且初始矫正高的患者Cobb角成功矫正了7度。
初始矫正高的依从性患者最终可预期矫正约7度,而初始矫正低的依从性患者可能维持侧弯程度。依从性差总是与侧弯进展相关。