Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Sam Jackson Hall, Suite 2360, 3181 S.W. Sam Jackson Park Road, Portland, OR, USA.
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
Spine Deform. 2021 May;9(3):697-702. doi: 10.1007/s43390-020-00265-4. Epub 2021 Feb 12.
While the Scoliosis Research Society (SRS) has established criteria for brace initiation in adolescent idiopathic scoliosis (AIS), there are no recommendations concerning other management issues. As the BrAIST study reinforced the utility of bracing, the SRS Non-Operative Management Committee decided to evaluate the consensus or discord in AIS brace management.
1200 SRS members were sent an online survey in 2017, which included 21 items concerning demographics, bracing indications, management, and monitoring. Free-text responses were analyzed and collated into common themes. Data were analyzed using Microsoft Excel 2013.
Of 218 respondents; 207 regularly evaluate and manage patients with AIS, and 205 currently prescribe bracing. 99% of respondents use bracing for AIS and the majority (89%) use the published SRS criteria, or a modified version, to initiate bracing. 85% do not use brace monitoring and 66% use both %-Cobb correction and fit criteria to evaluate brace adequacy. In contrast, other aspects of brace management demonstrated a high degree of practice variability. This was seen with a radiographic assessment of maturity level, hours prescribed, timing and frequency of radiographic evaluation, the use of nighttime bracing only, and the method and timing of brace discontinuation.
Although there is consensus in brace management amongst SRS members with respect to brace initiation and evaluation of adequacy, there is striking variability in how bracing for AIS is used. This variability may impact the overall efficacy of brace treatment and may be decreased with more robust guidelines from the SRS.
III.
虽然脊柱侧凸研究学会（SRS）已经制定了青少年特发性脊柱侧凸（AIS）支具起始的标准，但对于其他管理问题尚无建议。由于 BrAIST 研究加强了支具的作用，SRS 非手术管理委员会决定评估 AIS 支具管理中的共识或分歧。
2017 年，向 1200 名 SRS 成员发送了在线调查，其中包括 21 个项目，涉及人口统计学、支具适应证、管理和监测。对自由文本的回复进行了分析和整理，形成了共同的主题。使用 Microsoft Excel 2013 对数据进行分析。
在 218 名回复者中；207 人定期评估和管理 AIS 患者，205 人目前开具支具处方。99%的回复者使用支具治疗 AIS，大多数（89%）使用已发表的 SRS 标准或修改版来启动支具。85%的人不使用支具监测，66%的人使用 Cobb 角百分比矫正和适配标准来评估支具的充分性。相比之下，支具管理的其他方面显示出高度的实践变异性。这在成熟度水平的影像学评估、规定的小时数、影像学评估的时间和频率、仅夜间使用支具、支具停用的方法和时间等方面都有所体现。
尽管 SRS 成员在支具起始和充分性评估方面对支具管理达成了共识，但在 AIS 支具的使用方面存在显著的差异。这种变异性可能会影响支具治疗的整体效果，并且 SRS 制定更严格的指南可能会降低这种变异性。
III 级。
