University of Texas-Southwestern, Dallas, TX, USA.
Texas Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX, 75219, USA.
J Orthop Surg Res. 2021 Aug 31;16(1):540. doi: 10.1186/s13018-021-02650-9.
In-brace correction and brace compliance with thoraco-lumbo-sacral orthotic (TLSO) braces are associated with successful treatment of adolescent idiopathic scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not.
All skeletally immature (Risser 0-2) patients were treated for AIS (25-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 h a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation.
Ninety patients (F 82, M 8) with an average age of 12.1 (10.1-15.0) years, Risser grade 0 (0-2), BMI percentile 48.5 (0.0-98.8), and daily brace wear of 16.5 (12.1-21.6) h/day were treated for 24.3 (8.0-66.6) months. Patients went through 1.7 (1-4) braces on average. Forty-two out of 90 (46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5-100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014).
Patients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1 (95% CI 1.2-7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays.
ClinicalTrials.gov- NCT02412137 , initial registration date April 2015 LEVEL OF EVIDENCE: III.
支具内矫正和支具依从性与胸腰骶矫形器（TLSO）支具治疗青少年特发性脊柱侧凸（AIS）的成功相关。本文比较了影像学记录支具内矫正情况一致的患者与不一致的患者。
所有骨骼未成熟（Risser 0-2）的 AIS（25-45°）患者均接受全天 TLSO 支具治疗，支具配备有符合温度监测的依从性。所有患者每天至少佩戴支具 12 小时。支具失败定义为曲线进展至手术幅度（≥50°）。所有患者均随访至支具停用。
90 例患者（女性 82 例，男性 8 例），平均年龄 12.1（10.1-15.0）岁，Risser 分级 0（0-2），BMI 百分位数 48.5（0.0-98.8），每日支具佩戴时间 16.5（12.1-21.6）小时，治疗时间为 24.3（8.0-66.6）个月。患者平均更换 1.7（1-4）副支具。90 例患者中有 42 例（46.7%）存在一定程度的支具时间，但支具内矫正情况未知，平均占总治疗过程的 66.1%（11.5-100）。单因素分析显示，未进行重复支具 X 射线检查、大角度支具调整或新支具制作的患者，骨骼成熟度较低（Risser 0 和三辐射未闭合，p=0.028），整个治疗过程中佩戴的支具较多（2.0 副 vs 1.4 副，p<0.001），治疗时间较长（27 个月 vs 22 个月，p=0.022），支具失败率较高（47.6% vs 22.9%，p=0.014）。
与接受重复支具 X 射线检查的患者相比，未进行新的支具内 X 射线检查、大角度支具调整和/或新支具制作的患者，支具失败的风险高 3.1 倍（95%CI 1.2-7.6）。
ClinicalTrials.gov-NCT02412137，初始注册日期 2015 年 4 月。
III。
