Negrini Stefano, Minozzi Silvia, Bettany-Saltikov Josette, Chockalingam Nachiappan, Grivas Theodoros B, Kotwicki Tomasz, Maruyama Toru, Romano Michele, Zaina Fabio
Physical and Rehabilitation Medicine, University of Brescia, IRCCS Fondazione Don Gnocchi Milan, Brescia, Italy.
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
Spine (Phila Pa 1976). 2016 Dec 1;41(23):1813-1825. doi: 10.1097/BRS.0000000000001887.
A Cochrane systematic review.
To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological, and cosmetic issues.
Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. Although adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic.
We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015. We also checked reference lists and hand searched grey literature. Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. We used standard methodological procedures expected by the Cochrane Collaboration.
We included seven studies. Five were planned as RCTs, two as prospective controlled clinical trials. One RCT failed completely, another was continued as an observational study. There was very low quality evidence from one small RCT that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation.
Two studies showed that bracing did not change QoL during treatment, and QoL, back pain psychological and cosmetic issues in the long term (16 years.) All articles showed that bracing prevented curve progression. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children.
Cochrane系统评价。
评估对患有特发性脊柱侧凸（AIS）的青少年使用支具治疗与不治疗或其他治疗方法相比，在生活质量、残疾情况、肺部疾病、脊柱侧弯进展、心理和外观问题方面的疗效。
特发性脊柱侧弯是脊柱的三维畸形。最常见的形式在青少年期被诊断出来。尽管青少年特发性脊柱侧弯（AIS）在生长过程中可能进展并导致体表畸形，但通常没有症状。
我们检索了截至2015年2月的CENTRAL、MEDLINE、EMBASE、其他五个数据库以及两个试验注册库。我们还检查了参考文献列表并手工检索了灰色文献。纳入比较支具与不治疗、其他治疗、手术以及不同类型支具用于患有AIS的青少年的随机对照试验（RCT）和前瞻性对照队列研究。我们采用了Cochrane协作网期望的标准方法程序。
我们纳入了七项研究。五项计划为RCT，两项为前瞻性对照临床试验。一项RCT完全失败，另一项作为观察性研究继续进行。一项小型RCT提供了非常低质量的证据，表明在治疗期间，硬性支具和观察组之间的生活质量（QoL）没有显著差异。
两项研究表明，支具在治疗期间没有改变生活质量，并且在长期（16年）内对生活质量、背痛、心理和外观问题也没有影响。所有文章都表明支具可防止脊柱侧弯进展。RCT的高失败率表明在一个父母拒绝让孩子随机分组的领域进行RCT存在巨大困难。
1级
