Pellios Stavros, Kenanidis Eustathios, Potoupnis Michael, Tsiridis Eleftherios, Sayegh Fares E, Kirkos John, Kapetanos George A
Academic Orthopaedic Unit, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece.
Scoliosis Spinal Disord. 2016 Mar 9;11:3. doi: 10.1186/s13013-016-0065-z. eCollection 2016.
Scoliotic curves do not necessarily stop progressing at skeletal maturity. The factors that influence curve behavior following bracing are not fully determined. Our objectives were to evaluate the loss of the scoliotic curve correction in a cohort of patients treated with bracing during adolescence and to compare the outcomes of 18 versus 23 h of bracing at a mean of 25 years post brace removal.
Seventy-seven patients, who were successfully treated for Adolescent Idiopathic Scoliosis with Βoston brace, were re-evaluated 25 years after the end of their treatment. Patients were further divided in 2 matched groups; those wearing the brace for 23 h and those not wearing the brace at school-time, limiting the application of the brace to 18 h. The mean scoliotic curve was compared between groups before, during, just after bracing and 25 years post bracing. Validated in patients' native language forms of Short Form 36 and Oswestry Disability Index questionnaires were used to compare the quality of life between groups 25 years post bracing.
The mean age of the cohort was 40.4 (±3.2) years. They underwent long term follow up at a mean of 25.16 (±2.69) years after brace removal. The mean cohort scoliotic curve increased by 3.9 (±6.69) at 25 years since brace removal. There was however no significant difference in the mean Cobb angle of the cohort between pre brace and long term follow up period (p = 0.307). The 18 and 23 h application groups were comparable according to demographics and several bracing and scoliotic curve parameters. There was no significant difference in the mean curve magnitude between 18 and 23 h application groups at brace removal (p = 0.512) and at 25 years follow-up (p = 0.878). There was also no significant difference in the mean score of Quality of Life questionnaires between groups at long term follow up.
Scoliotic curves do not necessarily stop progressing after bracing. Bracing is effective treatment method with good long term results in appropriate patients. Since compliance was not objectively measured, we don't feel confident to give any indication about everyday dosage.
脊柱侧弯曲线在骨骼成熟后不一定会停止进展。影响支具治疗后曲线变化的因素尚未完全明确。我们的目的是评估一组青春期接受支具治疗的患者脊柱侧弯曲线矫正的丢失情况，并比较在平均去除支具25年后，每天佩戴支具18小时与23小时的治疗效果。
77例成功接受波士顿支具治疗青少年特发性脊柱侧弯的患者，在治疗结束25年后进行重新评估。患者进一步分为2个匹配组：一组每天佩戴支具23小时，另一组在上学期间不佩戴支具，将支具佩戴时间限制为18小时。比较两组在支具治疗前、治疗期间、刚结束支具治疗时以及支具治疗后25年的平均脊柱侧弯曲线。使用以患者母语形式呈现的简明健康状况调查问卷（Short Form 36）和奥斯威斯利功能障碍指数问卷（Oswestry Disability Index）比较两组在支具治疗后25年的生活质量。
该队列患者的平均年龄为40.4（±3.2）岁。在平均去除支具25.16（±2.69）年后接受长期随访。自去除支具25年后，该队列患者的平均脊柱侧弯曲线增加了3.9（±6.69）度。然而，支具治疗前与长期随访期间该队列患者的平均Cobb角无显著差异（p = 0.307）。根据人口统计学以及一些支具和脊柱侧弯曲线参数，每天佩戴支具18小时组和23小时组具有可比性。在去除支具时（p = 0.512）和25年随访时（p = 0.878），每天佩戴支具18小时组和23小时组的平均曲线严重程度无显著差异。在长期随访中，两组生活质量调查问卷的平均得分也无显著差异。
脊柱侧弯曲线在支具治疗后不一定会停止进展。支具治疗是一种有效的治疗方法，对合适的患者有良好的长期效果。由于未客观测量依从性，我们对给出任何关于每日佩戴时长的建议没有信心。
