Medical College of Wisconsin, Milwaukee, WI, USA.
Dept. of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
Stud Health Technol Inform. 2021 Jun 28;280:179-183. doi: 10.3233/SHTI210462.
Adolescent idiopathic scoliosis (AIS) is a complex condition characterized by a lateral curvature and axial rotational deformity of the spine. Though bracing is effective, a need remains to identify the effect brace type has on spine curvature. To examine differences in patient demographics between the Boston and Providence brace, determine the corrective change in Cobb angle and RVAD and investigate the effect of brace type on curvature over time. A retrospective chart review was conducted of 105 patients diagnosed with AIS from 2013-2016 at CHW. Five spinal parameters were measured: Cobb angle, Risser, RVAD, kyphosis and lordosis. Data was collected before bracing, in-brace and at 24 months. A final treatment outcome of either Cobb angle correction (reduction >5°), stabilization (change ±5°) or progression (deterioration >5°) was then evaluated. Providence brace provided significantly greater in-brace thoracolumbar Cobb angle and RVAD reduction in comparison to the Boston brace (Cobb angle -21.9° vs. -12.5°; RVAD: -1.8° vs. 1.62°). Similarly, Providence users had a significantly smaller increase in Cobb angle and RVAD over time (Cobb angle: thoracic 14.2° vs. 15.0°; thoracolumbar 23.6° vs. 26.0°; RVAD: 5.2° vs. 8.5°). Ultimately, no significant difference in final treatment outcome was established between brace groups. Although the Providence brace provides less of an increase in thoracic and thoracolumbar curvatures over time, both braces are an effective treatment and achieve comparable outcomes. Selection of braces may vary with primary curve angle, curve location, patient compliance and quality of life.
青少年特发性脊柱侧凸（AIS）是一种复杂的病症，其特征是脊柱的侧向弯曲和轴向旋转畸形。虽然支具治疗有效，但仍需要确定支具类型对脊柱弯曲的影响。本研究旨在通过回顾性病例分析，比较波士顿支具和 Providence 支具在患者特征、脊柱弯曲矫正和矢状面垂直轴（vertebral axial deviation，RVAD）方面的差异，探讨支具类型对脊柱弯曲的长期影响。研究对 2013 年至 2016 年期间在 CHW 诊断为 AIS 的 105 名患者进行了回顾性图表审查。共测量了 5 个脊柱参数：Cobb 角、Risser 征、RVAD、后凸和前凸。在支具治疗前、支具内和 24 个月时收集数据。然后评估最终治疗结果，即 Cobb 角矫正（减少>5°）、稳定（变化±5°）或进展（恶化>5°）。与波士顿支具相比，Providence 支具在支具内时提供了更大的胸腰椎 Cobb 角和 RVAD 矫正（Cobb 角-21.9°vs.-12.5°；RVAD：-1.8°vs.1.62°）。同样，Providence 支具使用者在随时间推移时 Cobb 角和 RVAD 的增加明显更小（Cobb 角：胸椎 14.2°vs.15.0°；胸腰椎 23.6°vs.26.0°；RVAD：5.2°vs.8.5°）。最终，两组支具之间的最终治疗结果没有显著差异。尽管 Providence 支具在随时间推移时提供的胸腰椎曲率增加较小，但两种支具都是有效的治疗方法，可达到类似的结果。支具的选择可能因主曲线角度、曲线位置、患者依从性和生活质量而异。
