Sun Weixiang, Zhou Jin, Sun Minghui, Qin Xiaodong, Qiu Yong, Zhu Zezhang, Xu Leilei
Department of Spine Surgery, The Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Department of Radiology, The Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Eur Spine J. 2017 Jun;26(6):1665-1669. doi: 10.1007/s00586-016-4839-z. Epub 2016 Nov 2.
To determine the relationship between low body mass index (BMI) and the outcome of brace treatment in patients with adolescent idiopathic scoliosis (AIS).
350 braced female AIS patients were included in this study. The baseline characteristics of the patient were recorded at their first visit, including age, Risser sign, digital skeletal age, BMI, curve pattern, and curve magnitude. Underweight was defined as lower than the 5th percentile of the sex- and age-specific BMI. The treatment was considered as a failure if the curve progressed more than 5°, or if patients underwent surgery. According to the final outcome of brace treatment, the cohort was divided into the success group and the failure group. A logistic regression model was created to determine the independent predictors of the bracing outcome.
24.5% (86/350) of the patients were identified as underweight at their initial visit, which was significantly higher than the rate of 13.1% (46/350) at the final follow-up (p < 0.001). At the initial visit of the patients, the rate of underweight was 17.6% (45/255) in the success group, which was significantly lower than the rate of 43.1% (41/95) in the failure group (p < 0.001). Logistic regression analysis showed that low BMI was significantly associated with bracing failure (p < 0.001).
The low BMI could be predictive of bracing failure in AIS patients, which should be taken into account when surgeons prescribe brace treatment to such patients.
确定青少年特发性脊柱侧凸（AIS）患者低体重指数（BMI）与支具治疗效果之间的关系。
本研究纳入350例接受支具治疗的女性AIS患者。在患者首次就诊时记录其基线特征，包括年龄、Risser征、数字化骨龄、BMI、侧弯类型和侧弯程度。体重过轻定义为低于特定性别和年龄的BMI第5百分位数。如果侧弯进展超过5°或患者接受了手术，则认为治疗失败。根据支具治疗的最终结果，将队列分为成功组和失败组。建立逻辑回归模型以确定支具治疗结果的独立预测因素。
24.5%（86/350）的患者在初次就诊时被确定为体重过轻，这显著高于最终随访时13.1%（46/350）的比例（p<0.001）。在患者初次就诊时，成功组体重过轻的比例为17.6%（45/255），显著低于失败组43.1%（41/95）的比例（p<0.001）。逻辑回归分析表明，低BMI与支具治疗失败显著相关（p<0.001）。
低BMI可能预示AIS患者支具治疗失败，外科医生在为这类患者开支具治疗处方时应予以考虑。
