Bulthuis Gerben J, Veldhuizen Albert G, Nijenbanning Gert
Department of Orthopaedics, University Medical Center of Groningen, Po.Box: 30.001, 9700 RB, Groningen, The Netherlands.
Eur Spine J. 2008 Feb;17(2):231-9. doi: 10.1007/s00586-007-0513-9. Epub 2007 Oct 10.
A prospective cohort study of skeletally immature idiopathic scoliotic patients treated with the TriaC brace. To determine if the TriaC brace is effective in preventing curve progression in immature adolescent idiopathic scoliotic patients with a very high risk of curve progression based on reported natural history data. The aim of the newly introduced TriaC brace is to reverse the pathologic transverse force pattern by externally applied and continuously present orthotic forces. In the frontal plane the force system used in the TriaC brace is similar to the force system of the conventional braces. However, in the sagittal plane the force system acts only on the thoracic region. In addition, the brace allows upper trunk flexibility without affecting the corrective forces during body motion. In a preliminary study it is demonstrated that the brace prevents further progression of both the Cobb angle and axial rotation in idiopathic scoliosis. Skeletally immature patients with idiopathic scoliosis with curves between 20 and 40 degrees were studied prospectively. Skeletally immature was defined as a Risser sign 0 or 1 for both boys and girls, or pre-menarche or less than 1-year post-menarche for girls. Curves of less than 30 degrees had to have documented progression before entry. The mean age of the patients at the start of treatment was 11.3 +/- 3.1 years. All measurements were collected by a single observer, and all patients were followed up to skeletal maturity. Treatment was complete for all participants when they had reached Risser sign 4 and did not show any further growth at length measurements. This was at a mean age of 15.6 +/- 1.1 years, with a mean follow-up of 1.6 years post bracing. In our study a successful outcome was obtained in 76% of patients treated with the TriaC brace. Comparing our data to literature data on natural history of a similar cohort shows that the TriaC brace significantly alters the predicted natural history. The current study demonstrates that treatment with the TriaC brace reduces the scoliosis, and that the achieved correction is maintained in some degree after skeletal maturity is reached and bracing is discontinued. It also prevents further progression of the Cobb angle in idiopathic scoliosis. The new brace does not differ from the conventional braces as far as maintaining the deformity is concerned.
一项对使用TriaC支具治疗的骨骼未成熟特发性脊柱侧凸患者的前瞻性队列研究。基于已报道的自然病史数据，确定TriaC支具在预防具有极高侧弯进展风险的未成熟青少年特发性脊柱侧凸患者的侧弯进展方面是否有效。新推出的TriaC支具的目的是通过外部施加且持续存在的矫形力来逆转病理性横向力模式。在额状面，TriaC支具使用的力系统与传统支具的力系统相似。然而，在矢状面，力系统仅作用于胸部区域。此外，该支具允许上躯干灵活运动，而在身体运动过程中不影响矫正力。在一项初步研究中表明，该支具可防止特发性脊柱侧凸患者的Cobb角和轴向旋转进一步进展。对骨骼未成熟、侧弯在20度至40度之间的特发性脊柱侧凸患者进行了前瞻性研究。骨骼未成熟定义为男孩和女孩的Risser征均为0或1，或女孩处于初潮前或初潮后不到1年。小于30度的侧弯在入组前必须有记录的进展情况。患者开始治疗时的平均年龄为11.3±3.1岁。所有测量均由一名观察者收集，所有患者均随访至骨骼成熟。当所有参与者达到Risser征4且长度测量未显示进一步生长时，治疗结束。此时的平均年龄为15.6±1.1岁，支具治疗后的平均随访时间为1.6年。在我们的研究中，使用TriaC支具治疗的患者中有76%获得了成功的结果。将我们的数据与类似队列自然病史的文献数据进行比较表明，TriaC支具显著改变了预测的自然病史。当前研究表明，使用TriaC支具治疗可减轻脊柱侧凸，并且在达到骨骼成熟并停止支具治疗后，所实现的矫正程度在一定程度上得以维持。它还可防止特发性脊柱侧凸患者的Cobb角进一步进展。就维持畸形而言，新支具与传统支具没有差异。
