Guo Jing, Lam Tsz Ping, Wong Man Sang, Ng Bobby Kin Wah, Lee Kwong Man, Liu King Lok, Hung Lik Hang, Lau Ajax Hong Yin, Sin Sai Wing, Kwok Wing Kwan, Yu Fiona Wai Ping, Qiu Yong, Cheng Jack Chun Yiu
Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Eur Spine J. 2014 Dec;23(12):2650-7. doi: 10.1007/s00586-013-3146-1. Epub 2013 Dec 31.
SpineCor is a relatively innovative brace for non-operative treatment of adolescent idiopathic scoliosis (AIS). However, the effectiveness of SpineCor still remains controversial. The objective of the current study was to compare the treatment outcomes of SpineCor brace with that of rigid brace following the standardized Scoliosis Research Society (SRS) criteria on AIS brace study.
Females subjects with AIS and aged 10-14 were randomly allocated into two groups undergoing treatment of SpineCor (S Group, n = 20) or rigid brace (R Group, n = 18). During SpineCor treatment, patients who had curve progression of >5° would be required to switch to rigid brace treatment. The effectiveness of the two brace treatments was assessed using the SRS standardized criteria.
Before skeletal maturity, 7 (35.0%) patients in the S Group and 1 (5.6%) patient in the R Group had curve progression >5° (P = 0.026). At skeletal maturity, 5 of the 7 (71.4%) patients who failed with SpineCor bracing showed control from further progression by changing to rigid bracing. At the latest follow-up with a mean duration of 45.1 months after skeletally maturity, 29.4% of patients who were successfully treated by rigid brace showed further curve progression beyond skeletal maturity, versus 38.5% of patients in the SpineCor group (P > 0.05). For both groups, the primary curves were slightly improved at the time of brace weaning, but additionally increased at the latest follow-up, with a rate of 1.5° per year for post-maturity progression.
Curve progression rate was found to be significantly higher in the SpineCor group when compared with the rigid brace group. Changing to rigid bracing could control further curve progression for majority of patients who previously failed with SpineCor bracing. For both SpineCor and rigid brace treatments, 30-40% of patients who were originally successfully treated by bracing would exhibit further curve progression beyond skeletal maturity. The post-maturity progression rate was found to be 1.5° per year in the current study, which was relatively greater than those reported before.
SpineCor是一种用于青少年特发性脊柱侧凸（AIS）非手术治疗的相对创新型支具。然而，SpineCor的有效性仍存在争议。本研究的目的是按照脊柱侧凸研究学会（SRS）关于AIS支具研究的标准化标准，比较SpineCor支具与刚性支具的治疗效果。
将年龄在10至14岁的AIS女性受试者随机分为两组，分别接受SpineCor治疗（S组，n = 20）或刚性支具治疗（R组，n = 18）。在SpineCor治疗期间，侧弯进展超过5°的患者将被要求改用刚性支具治疗。使用SRS标准化标准评估两种支具治疗的效果。
在骨骼成熟前，S组有7名（35.0%）患者和R组有1名（5.6%）患者侧弯进展超过5°（P = 0.026）。在骨骼成熟时，7名SpineCor支具治疗失败的患者中有5名（71.4%）通过改用刚性支具控制了进一步进展。在骨骼成熟后平均随访45.1个月的最新随访中，刚性支具成功治疗的患者中有29.4%在骨骼成熟后出现了进一步的侧弯进展，而SpineCor组为38.5%（P > 0.05）。对于两组，主弯在支具停用时有轻微改善，但在最新随访时进一步增加，成熟后进展速度为每年1.5°。
发现SpineCor组的侧弯进展率明显高于刚性支具组。改用刚性支具可控制大多数先前SpineCor支具治疗失败患者的进一步侧弯进展。对于SpineCor和刚性支具治疗，最初通过支具成功治疗的患者中有30 - 40%在骨骼成熟后会出现进一步的侧弯进展。本研究发现成熟后进展速度为每年1.5°，相对高于之前报道的速度。
