Weiss Hans-Rudolf, Werkmann Mario
Orthopedic Rehabilitation Services, Alzeyerstr, Germany.
Stud Health Technol Inform. 2012;176:407-10.
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. Prospective cohort studies are available using the SRS inclusion criteria for studies on bracing. This seems to provide a great advantage to compare different strategies of bracing against each other. As we have gathered all data of the patients treated with a Chêneau light TM between June 2005 and November 2007 it was possible to identify the sample of patients fulfilling the SRS inclusion criteria from the whole sample.
34 patients (of 152) fulfilled the SRS inclusion criteria with an average age of 12.06 years (10 - 13 years), average Cobb angle of 31 degrees (25 - 40°), an average Risser stage of 0,35, average in-brace Cobb angle of 13° (= 59% of in-brace correction). There were 17 thoracic, 10 double major, 6 lumbar and 2 thoracolumbar curve patterns. After change of workplace of the second author the patients could not be followed up as planned. Therefore a telephone interview was performed by the second author.
28 patients (average age 16.5 years) have been reached, 9 of them were still under treatment. No patient has been operated (Rate of surgery 0%) and only one was not satisfied with cosmetic outcome of treatment.
Rate of surgery was far less than reported in recent studies using the same inclusion criteria even when all drop outs where rated as failures.
Rate of surgery can be reduced with the help of Chêneau braces of the latest standard and satisfactory in-brace correction. Brace treatment with the Chêneau brace seems effective and therefore clearly is indicated. Clinical outcomes may be more important for the patient than radiologic outcomes.
关于保守治疗脊柱侧弯的研究结果，在所用纳入标准方面差异很大。有前瞻性队列研究采用了脊柱侧弯研究学会（SRS）的支具治疗研究纳入标准。这似乎为相互比较不同的支具治疗策略提供了很大优势。由于我们收集了2005年6月至2007年11月间使用Chêneau light TM支具治疗的患者的所有数据，所以能够从整个样本中确定符合SRS纳入标准的患者样本。
152名患者中有34名符合SRS纳入标准，平均年龄12.06岁（10 - 13岁），平均Cobb角31度（25 - 40°），平均Risser分期0.35，平均支具内Cobb角13°（=支具内矫正的59%）。有17例胸椎侧弯、10例双主弯、6例腰椎侧弯和2例胸腰段侧弯类型。在第二作者更换工作地点后，患者未能按计划进行随访。因此，由第二作者进行了电话访谈。
联系到了28名患者（平均年龄16.5岁），其中9名仍在接受治疗。没有患者接受手术（手术率为0%），只有1名患者对治疗的美容效果不满意。
即使将所有失访患者都视为治疗失败，手术率也远低于近期使用相同纳入标准的研究报告。
采用最新标准的Chêneau支具并获得满意的支具内矫正，可降低手术率。使用Chêneau支具进行支具治疗似乎有效，因此显然是适用的。对患者而言，临床结果可能比影像学结果更重要。
