Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Orthopedics, OLVG, Amsterdam, The Netherlands.
Spine (Phila Pa 1976). 2022 Apr 15;47(8):E353-E361. doi: 10.1097/BRS.0000000000004305. Epub 2021 Nov 29.
Systematic literature review.
The aim of this study was to systematically review the literature and provide an overview of reported predictive factors on initial in-brace correction in patients with idiopathic scoliosis (IS).
Brace therapy is the best proven non-surgical treatment for IS. There is strong evidence that lack of initial in-brace correction is associated with brace treatment failure. To improve initial in-brace corrections and subsequently long-term brace treatment success, knowledge about factors influencing initial in-brace correction is a prerequisite.
A systematic literature search was performed in Pubmed, Embase, Web-of-Science, Scopus, Cinahl, and Cochrane in November 2020. Studies which reported factors influencing initial in-brace correction in IS patients treated with brace therapy were considered eligible for inclusion.
Of the 4562 potentially eligible articles identified, 28 studies fulfilled the inclusion criteria and were included in this systematic review. Nine studies (32%) were classified as high quality studies and the remaining 19 studies (68%) as low quality. Thirty-four different reported factors were collected from the included studies. Strong evidence was found for increased curve flexibility as favorable predictive factor for initial in-brace correction. Moderate evidence was found for thoracolumbar or lumbar curve pattern as favourable predictive factor, and double major curve pattern as unfavourable predictive factor for initial in-brace correction. Also moderate evidence was found that there is no significant difference on initial in-brace correction between computer-aided design and manufacturing systems (CAD/CAM) braces with or without finite element models (FEM) simulation, and braces fabricated using the conventional plaster-cast.
The results of this systematic review indicate that increased curve flexibility is strongly associated with increased initial in-brace correction.Level of Evidence: 1.
系统文献回顾。
本研究旨在系统回顾文献，综述特发性脊柱侧凸（IS）患者支具治疗初始矫正的报告预测因素。
支具治疗是 IS 最佳的经证实的非手术治疗方法。有强有力的证据表明，初始支具矫正不足与支具治疗失败有关。为了提高初始支具矫正效果，进而提高长期支具治疗成功率，了解影响初始支具矫正的因素是前提。
2020 年 11 月，我们在 Pubmed、Embase、Web-of-Science、Scopus、Cinahl 和 Cochrane 中进行了系统的文献检索。报告了支具治疗的 IS 患者初始支具矫正影响因素的研究被认为符合纳入标准。
在 4562 篇潜在的合格文章中，28 项研究符合纳入标准，并被纳入本系统评价。9 项研究（32%）被归类为高质量研究，其余 19 项研究（68%）为低质量研究。从纳入的研究中收集了 34 个不同的报告因素。有强有力的证据表明，曲线灵活性增加是初始支具矫正的有利预测因素。有中度证据表明，胸腰段或腰椎曲线形态是初始支具矫正的有利预测因素，双主曲线形态是初始支具矫正的不利预测因素。也有中度证据表明，具有或不具有有限元模型（FEM）模拟的计算机辅助设计和制造系统（CAD/CAM）支具与常规石膏模型支具在初始支具矫正方面无显著差异。
本系统评价的结果表明，曲线灵活性增加与初始支具矫正增加密切相关。证据等级：1。
