Wanke-Jellinek Lorenz, Krenauer Alexander, Wuertinger Christoph, Storzer Bastian, Haasters Florian, Mehren Christoph
Spine Center, Schön Klinik München Harlaching, Munich, Germany.
Academic Teaching Hospital and Spine Research Institute, Paracelsus Private Medical University Salzburg, Salzburg, Austria.
Global Spine J. 2024 Mar;14(2):519-525. doi: 10.1177/21925682221114051. Epub 2022 Aug 16.
Retrospective consecutive cohort study.
For patients with mild to moderate adolescent idiopathic scoliosis (AIS), bracing is the standard therapy to prevent progression of deformity. Still, not all patients benefit from treatment in the same way. Therefore, predictive parameters are needed to determine if patients are likely to benefit from brace therapy.
Fourty-five AIS patients treated with a Chêneau brace were evaluated retrospectively. Inclusion criteria were based on SRS-criteria. Whole spine X-rays were performed pre-brace, in-brace, and at least 6 months after termination of brace treatment. Gender, age, Risser's sign, vertebral rotation determined by Nash and Moe grading system, in-brace correction and in-brace time per day were parameters evaluated. Treatment success and failure groups were compared to determine possible predictive parameters for successful brace treatment.
Chêneau brace treatment was successful preventing curve progression in 69%. We found significant differences between success and failure group concerning age (14 ± .22 vs 12.4 ± .4; < .001) and Risser's sign (1.71 ± .16 vs .5 ± .17; < .001) at beginning of brace treatment. Most significantly, initial in-brace curve correction was correlated with successful outcome after brace treatment (r = .64 ( < .001)).
As one of few studies adhering to the criteria defined by the Scoliosis Research Society our study shows reliable predictive parameters for Chêneau brace treatment success in patients with AIS. Data shown in this paper will help to differentiate AIS patients who are likely to benefit from adequate bracing therapy from those who could rather benefit from early surgical treatment.
回顾性连续队列研究。
对于轻度至中度青少年特发性脊柱侧凸（AIS）患者，支具治疗是预防畸形进展的标准疗法。然而，并非所有患者都能以相同方式从治疗中获益。因此，需要预测参数来确定患者是否可能从支具治疗中获益。
对45例接受施诺支具治疗的AIS患者进行回顾性评估。纳入标准基于脊柱侧凸研究学会（SRS）标准。在佩戴支具前、佩戴支具期间以及支具治疗结束后至少6个月进行全脊柱X光检查。评估的参数包括性别、年龄、里塞尔征、由纳什和莫伊分级系统确定的椎体旋转、佩戴支具期间的矫正情况以及每天佩戴支具的时间。比较治疗成功组和失败组，以确定成功支具治疗的可能预测参数。
施诺支具治疗成功预防了69%的侧弯进展。我们发现，在支具治疗开始时，成功组和失败组在年龄（14±0.22岁 vs 12.4±0.4岁；P<0.001）和里塞尔征（1.71±0.16 vs 0.5±0.17；P<0.001）方面存在显著差异。最显著的是，佩戴支具初期的侧弯矫正与支具治疗后的成功结果相关（r = 0.64，P<0.001）。
作为少数遵循脊柱侧凸研究学会定义标准的研究之一，我们的研究显示了施诺支具治疗AIS患者成功的可靠预测参数。本文所示数据将有助于区分可能从适当支具治疗中获益的AIS患者和可能从早期手术治疗中获益的患者。
