Coillard Christine, Vachon Valerie, Circo Alin B, Beauséjour Marie, Rivard Charles H
Research Center, Sainte-Justine Hospital, Montreal, Quebec, Canada.
J Pediatr Orthop. 2007 Jun;27(4):375-9. doi: 10.1097/01.bpb.0000271330.64234.db.
The purpose of this prospective observational study was to evaluate the effectiveness of the Dynamic SpineCor brace for adolescent idiopathic scoliosis in accordance with the standardized criteria proposed by the Scoliosis Research Society Committee on Bracing and Nonoperative Management. They proposed these guidelines to make the comparison among studies more valid and reliable. From 1993 to 2006, 493 patients were treated using the SpineCor brace. Two hundred forty-nine patients met the criteria for inclusion, and 79 patients were still actively being treated. Overall, 170 patients have a definitive outcome. All girls were premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness included (1) percentage of patients who have 5 degrees or less curve progression, and percentage of patients who have 6 degrees or more progression; (2) percentage of patients who have been recommended/undergone surgery before skeletal maturity; (3) percentage of patients with curves exceeding 45 degrees at maturity (end of treatment); and (4) Two-year follow-up beyond maturity to determine the percentage of patients who subsequently underwent surgery. Successful treatment (correction, >5 degrees, or stabilization, +/-5 degrees) was achieved in 101 (59.4%) of the 170 patients from the time of the fitting of the SpineCor brace to the point in which it was discontinued. Thirty-nine immature patients (22.9%) required surgical fusion while receiving treatment. Two (1.2%) of 170 patients had curves exceeding 45 degrees at maturity. One mature patient (2.1%) required surgery within 2 years of follow-up beyond skeletal maturity. The conclusion drawn from these findings is that the SpineCor brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, positive outcomes are maintained after 2 years because 45 (95.7%) of 47 patients stabilized or corrected their end of bracing Cobb angle up to 2 years after bracing. Therapeutic study-investigating the results of treatment: level II.
这项前瞻性观察性研究的目的是，根据脊柱侧弯研究学会支具与非手术治疗委员会提出的标准化标准，评估Dynamic SpineCor支具治疗青少年特发性脊柱侧弯的有效性。该委员会提出这些指导方针是为了使不同研究之间的比较更有效、更可靠。1993年至2006年期间，493例患者使用SpineCor支具进行治疗。249例患者符合纳入标准，79例患者仍在接受积极治疗。总体而言，170例患者有明确的治疗结果。所有女孩均处于月经初潮前或月经初潮后不到1年。支具有效性评估包括：(1) 侧弯进展5度或更小的患者百分比，以及侧弯进展6度或更大的患者百分比；(2) 在骨骼成熟前被推荐/接受手术的患者百分比；(3) 治疗结束时（成熟时）侧弯超过45度的患者百分比；(4) 成熟后进行两年随访，以确定随后接受手术的患者百分比。从佩戴SpineCor支具到停用期间，170例患者中有101例（59.4%）获得成功治疗（矫正，>5度，或稳定，+/-5度）。39例未成熟患者（22.9%）在接受治疗期间需要手术融合。170例患者中有2例（1.2%）在成熟时侧弯超过45度。1例成熟患者（2.1%）在骨骼成熟后的两年随访期内需要手术。这些研究结果得出的结论是，SpineCor支具治疗青少年特发性脊柱侧弯有效。此外，47例患者中有45例（95.7%）在支具治疗后长达两年的时间里，其支具治疗末期的Cobb角保持稳定或得到矫正，因此两年后仍保持积极的治疗效果。治疗性研究——调查治疗结果：二级。
