Department of Orthopaedics and Traumatology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece.
Director Physical and Rehabilitation Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Prosthet Orthot Int. 2022 Aug 1;46(4):383-391. doi: 10.1097/PXR.0000000000000117. Epub 2022 Mar 23.
This review presents the state of the art according to the current evidence on nonoperative treatment for adolescent idiopathic scoliosis, focusing on bracing. The definition of braces for the treatment of adolescent idiopathic scoliosis and a short history are provided. The analysis includes biomechanics, types, existing classifications, indications for treatment, time of brace wear and weaning, adherence, three-dimensional modeling, use of ultrasound imaging for bracing, management of treatment, issue of immediate in-brace correction, and documentation of the outcomes usually assessed for brace treatment, including the quality-of-life issues. According to the current evidence, there are two randomized control trials in favor of bracing. There are insufficient data on the superiority of one brace over another, although it is possible to classify and grade braces for efficacy from nonrigid to rigid and very rigid. Nevertheless, there is consensus on patients' management on the need for teamwork focusing on adherence to treatment, acceptability, and family and patient involvement.
这篇综述根据目前关于青少年特发性脊柱侧凸非手术治疗的证据,重点介绍支具治疗。提供了支具治疗青少年特发性脊柱侧凸的定义和简史。分析包括生物力学、类型、现有分类、治疗适应证、支具佩戴和脱支时间、依从性、三维建模、超声成像在支具治疗中的应用、治疗管理、支具内即刻矫正问题以及通常评估支具治疗结果的文献记录,包括生活质量问题。根据目前的证据,有两项随机对照试验支持支具治疗。关于一种支具优于另一种支具的优势,数据不足,尽管可以将支具的疗效从非刚性到刚性和非常刚性进行分类和分级。然而,对于需要团队合作的患者管理,包括对治疗的依从性、可接受性以及家庭和患者的参与,已经达成共识。