Wynne James H, Houle Lauren R
Boston Orthotics & Prosthetics, Avon, MA 02322, USA.
Children (Basel). 2022 Jun 7;9(6):842. doi: 10.3390/children9060842.
Adolescent idiopathic scoliosis (AIS) is characterized by a lateral curvature of the spine with a Cobb angle greater than 10 degrees, accompanied by rotation of the vertebral body. Bracing has been shown to be effective in halting the progression of at-risk curves, and, in some cases, even improving the Cobb angle by 6° or more. The Boston Brace 3D is part of the Boston Orthotics and Prosthetics standardized scoliosis program. The orthosis is custom-fabricated from scans, computer-aided design (CAD), and computer-aided manufactured (CAM) thoracolumbosacral orthosis used in the non-operative management of AIS.
To evaluate the outcomes of a scoliosis program utilizing the Boston Brace 3D orthosis for patients with AIS, based on SRS and SOSORT criteria.
Retrospective study.
An electronic medical records search was conducted to identify first-time brace wearers fitted between 1 January 2018, and 30 June 2019, at Boston Orthotics and Prosthetics Boston area clinics that met the SRS/SOSORT research guidelines. The initial out-of-brace, in-brace, and last follow-up X-rays (taken at least 12 months after fitting) were compared.
84% of patients presenting with a single curve and 69% of patients with a double curve saw their curves improve (reduced 6° or more) or remain unchanged (±5°). Thirty-one patients started with a single curve between 25° and 30°, and thirty-two presented at 30° or below. Fifty-nine patients started with a double curve between 25° and 30°, and 59 patients presented at 30° or below. In general, the patients who wore their brace for more hours per day saw improved results.
The Boston Brace 3D program is effective in controlling (and in some cases improving) curve progression in the non-operative management of adolescent idiopathic scoliosis. The approach is a repeatable system, as shown in this cohort of thirteen clinicians across six area clinics following the Boston Brace 3D clinical guidelines.
青少年特发性脊柱侧凸（AIS）的特征是脊柱出现大于10度的Cobb角侧弯，并伴有椎体旋转。支具已被证明能有效阻止有进展风险的侧弯发展，在某些情况下，甚至能使Cobb角改善6°或更多。波士顿3D支具是波士顿矫形与假肢标准化脊柱侧凸治疗方案的一部分。该矫形器是根据扫描、计算机辅助设计（CAD）和计算机辅助制造（CAM）定制的胸腰骶矫形器，用于AIS的非手术治疗。
根据SRS和SOSORT标准，评估使用波士顿3D支具的脊柱侧凸治疗方案对AIS患者的治疗效果。
回顾性研究。
对2018年1月1日至2019年6月30日期间在波士顿矫形与假肢波士顿地区诊所首次佩戴支具且符合SRS/SOSORT研究指南的患者进行电子病历检索。比较初次未佩戴支具、佩戴支具时及最后一次随访（佩戴支具至少12个月后拍摄）的X线片。
单弯患者中84%以及双弯患者中69%的侧弯得到改善（减少6°或更多）或保持不变（±5°）。31例患者初诊时单弯角度在25°至30°之间，32例患者初诊时单弯角度在30°及以下。59例患者初诊时双弯角度在25°至30°之间，59例患者初诊时双弯角度在30°及以下。总体而言，每天佩戴支具时间更长的患者治疗效果更好。
波士顿3D支具治疗方案在青少年特发性脊柱侧凸的非手术治疗中能有效控制（在某些情况下改善）侧弯进展。如本研究中六家地区诊所的13名临床医生按照波士顿3D临床指南治疗的队列所示，该方法是一个可重复的系统。
