按照脊柱侧弯研究学会支具研究标准，大阪医科大学（OMC）支具治疗青少年特发性脊柱侧弯的疗效。
Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria.
作者信息
Kuroki Hiroshi, Inomata Naoki, Hamanaka Hideaki, Higa Kiyoshi, Chosa Etsuo, Tajima Naoya
机构信息
Department of Orthopaedic Surgery, National Hospital Organization Miyazaki Higashi Hospital, 4374-1 Tayoshi Ooaza, Miyazaki, 880-0911 Japan.
Department of Orthopaedic Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan.
出版信息
Scoliosis. 2015 Apr 11;10:12. doi: 10.1186/s13013-015-0036-9. eCollection 2015.
BACKGROUND
The efficacy of brace treatment for patients with adolescent idiopathic scoliosis (AIS) remains controversial. To make comparisons among studies more valid and reliable, the Scoliosis Research Society (SRS) has standardized criteria for brace studies in patients with AIS. The purpose of this study was to evaluate the efficacy of the Osaka Medical College (OMC) brace for AIS in accordance with the modified standardized criteria proposed by the SRS committee on bracing and non-operative management.
METHODS
From 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. Patients were instructed to wear the brace for a minimum of 20 hours per day at the beginning of brace treatment. The mean duration of brace treatment was 4 years and 8 months. We examined the initial brace correction rate and the clinical outcomes of main curves evaluated by curve progression and surgical rate, and the compliance evaluated by the instruction adherence rate for all cases. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria.
RESULTS
The average initial brace correction rate was 46.8%. In 10 cases the curve progressed, 6 cases the curve improved, and 15 cases the curve remained unchanged (success rate: 67.7%). The mean instruction adherence rate, that was defined the percentage of the visits that patients declared they mostly followed our instruction to total visits, was 53.7%. The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% (88.2%) as compared with in those 50% or less (42.8%).
CONCLUSIONS
OMC brace treatment for AIS patients could alter the natural history and significantly decreased the progression of curves to the threshold for surgical intervention. Better instruction adherence of brace wear associated with greater success.
背景
青少年特发性脊柱侧凸（AIS）患者支具治疗的疗效仍存在争议。为使各项研究之间的比较更有效、可靠，脊柱侧凸研究学会（SRS）制定了AIS患者支具研究的标准化标准。本研究的目的是根据SRS支具与非手术治疗委员会提出的修改后的标准化标准，评估大阪医科大学（OMC）支具治疗AIS的疗效。
方法
1999年至2010年，对31例新佩戴OMC支具且符合修改后的SRS标准的AIS连续患者进行研究。研究包括2名男孩和29名女孩，平均年龄为12岁0个月。在支具治疗开始时，患者被要求每天至少佩戴20小时支具。支具治疗的平均持续时间为4年8个月。我们检查了初始支具矫正率、通过曲线进展和手术率评估的主曲线临床结果，以及通过所有病例的医嘱依从率评估的依从性。根据SRS判断标准，如果曲率增加≥6°，则认为支具治疗的临床过程为进展；如果曲率降低≥6°，则认为是改善。
结果
平均初始支具矫正率为46.8%。10例曲线进展，6例曲线改善，15例曲线无变化（成功率：67.7%）。平均医嘱依从率（定义为患者宣称大部分遵循医嘱的就诊次数占总就诊次数的百分比）为53.7%。医嘱依从率大于50%的患者组成功率（88.2%）在统计学上高于医嘱依从率为50%或更低的患者组（42.8%）。
结论
OMC支具治疗AIS患者可改变其自然病程，并显著降低曲线进展至手术干预阈值的程度。更好的支具佩戴医嘱依从性与更高的成功率相关。
Zotero 插件