查尔斯顿夜间弯曲支具治疗青少年特发性脊柱侧弯的有效性。

Effectiveness of the Charleston night-time bending brace in the treatment of adolescent idiopathic scoliosis.

作者信息

Lee Choon Sung, Hwang Chang Ju, Kim Dong-Jun, Kim Jae Hyan, Kim Yung-Tae, Lee Mi Young, Yoon So Jung, Lee Dong-Ho

机构信息

Scoliosis Center, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

出版信息

J Pediatr Orthop. 2012 Jun;32(4):368-72. doi: 10.1097/BPO.0b013e3182561193.

DOI:10.1097/BPO.0b013e3182561193

PMID:22584837

Abstract

BACKGROUND

Part-time or night-time bracing has been introduced to address the poor compliance and psychological burden of full-time bracing. The results of various bracing methods vary, however, due to a lack of consistent inclusion criteria and definitions of brace effectiveness. We have evaluated the effectiveness of the Charleston night-time bending brace in the treatment of adolescent idiopathic scoliosis based on the new standardized criteria proposed by the Scoliosis Research Society.

METHODS

To be included in this study, patients met the following criteria proposed by the Scoliosis Research Society: diagnosis of adolescent idiopathic scoliosis, age 10 years and older when the orthosis was prescribed, Risser 0-2, a primary curve magnitude of 25 to 40 degrees, and no prior treatment. A total of 95 patients (87 girls, 8 boys) were included.

RESULTS

At skeletal maturity, 80 patients (84.2%) had 5 degrees or less curve progression and 15 (15.8%) had 6 degrees or more progression. Seven patients (7.8%) were recommended to undergo or underwent surgery before skeletal maturity. Eleven patients (12.6%) progressed beyond 45 degrees. According to these 3 criteria, the Charleston night-time brace was successful in 74 patients (77.9%). Depending on curve type, we observed success rates of 78.3% (47/60) for double, 71.4% (15/21) for thoracic, 83.3% (5/6) for thoracolumbar, and 87.5% (7/8) for lumbar curves. Success rates of 80.0% (36/45) and 76.0% (38/50) were observed in patients with curve magnitudes at bracing of 25 to 30 degrees and 31 to 40 degrees, respectively. Patients with high apex curves had a 67.6% (23/34) success rate, and those with low apex curves had 83.0% (39/47) success rate. Brace success rates among patients with initial Risser signs of 0, 1, and 2 were 68.8% (22/32), 80.6% (25/31), and 84.4% (27/32), respectively.

CONCLUSIONS

Compared with the results of previous natural history and conventional brace study, the Charleston night-time bending brace is effective for the treatment of adolescent idiopathic scoliosis.

LEVEL OF EVIDENCE

Level VI.

摘要

背景

为解决全天佩戴支具时依从性差和心理负担重的问题，引入了兼职或夜间佩戴支具的方法。然而，由于缺乏统一的纳入标准和支具疗效定义，各种支具治疗方法的结果各不相同。我们根据脊柱侧凸研究学会提出的新的标准化标准，评估了查尔斯顿夜间弯曲支具治疗青少年特发性脊柱侧凸的疗效。

方法

纳入本研究的患者符合脊柱侧凸研究学会提出的以下标准：诊断为青少年特发性脊柱侧凸，开具矫形器时年龄10岁及以上，Risser分级0 - 2级，主弯角度25至40度，且未曾接受过治疗。共纳入95例患者（87例女孩，8例男孩）。

结果

在骨骼成熟时，80例患者（84.2%）的侧弯进展为5度或更小，15例（15.8%）进展为6度或更大。7例患者（7.8%）在骨骼成熟前被建议接受或接受了手术。11例患者（12.6%）侧弯进展超过45度。根据这3项标准，查尔斯顿夜间支具治疗成功的患者有74例（77.9%）。根据侧弯类型，我们观察到双弯型成功率为78.3%（47/60），胸弯型为71.4%（15/21），胸腰弯型为83.3%（5/6），腰弯型为87.5%（7/8）。支具佩戴时侧弯角度为25至30度和31至4度的患者成功率分别为80.0%（36/45）和76.0%（38/50）。顶椎高的患者成功率为67.6%（23/34），顶椎低的患者成功率为83.0%（39/47）。初始Risser分级为0、1和2级的患者中，支具治疗成功率分别为68.8%（22/32）、80.6%（25/31）和84.4%（27/32）。