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定制附加夜间支具对青少年特发性脊柱侧凸全天支具治疗的影响。

Impact of customized add-on nighttime bracing in full-time brace treatment of adolescent idiopathic scoliosis.

机构信息

University Center of Orthopaedic, Trauma & Plastic Surgery (OUPC), University Hospital Carl Gustav Carus of Technische Universität Dresden, Dresden, Germany.

University Comprehensive Spine Center (UCSC), University Hospital Carl Gustav Carus of Technische Universität Dresden, Dresden, Germany.

出版信息

PLoS One. 2023 Jan 26;18(1):e0278421. doi: 10.1371/journal.pone.0278421. eCollection 2023.

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

Bracing is an accepted standard therapy for idiopathic scoliosis at Cobb angle ranges between 25° and 40°. However, it is unclear, if a specifically tailored regimen of daytime and nighttime braces (= double brace) yields superior results compared to the standard treatment (single brace for day and night).

METHODS

One-hundred-fifteen patients with adolescent idiopathic scoliosis (AIS) were assessed before initiation of bracing treatment and at the final follow-up 2 years after deposition of the brace. They were divided into two groups: double-brace group (n = 66, 4 male, 62 female, age 13.1 ± 1.9 (mean ± SD), primary curvature thoracic n = 35, lumbar n = 31) and single-brace group (n = 49, 8 male, 41 female, age 14.1 ± 1.9, primary curvature thoracic n = 18, lumbar n = 31). Each patient underwent clinical and radiological examinations and Cobb angles were measured.

RESULTS

Both therapy regimens succeeded to either stop progression or improve scoliosis in over 85% of cases. The nighttime brace showed a significantly higher primary correction than the daytime brace. Nevertheless, there was no significant difference in treatment success in the 2-year follow-up (p = 0.58).

CONCLUSION

It seems to be sufficient to treat idiopathic scoliosis with one well-tailored brace for day- and nighttime.

摘要

研究设计

回顾性队列研究。

目的

支具矫形是 Cobb 角在 25°至 40°之间的特发性脊柱侧凸的一种公认的标准治疗方法。然而,目前尚不清楚,与标准治疗(白天和晚上均使用单支具)相比,专门定制的白天和晚上支具(双支具)方案是否会产生更好的结果。

方法

115 例青少年特发性脊柱侧凸(AIS)患者在开始支具治疗前和支具佩戴 2 年后的最终随访时进行评估。他们分为两组:双支具组(n = 66,4 名男性,62 名女性,年龄 13.1 ± 1.9(均值 ± 标准差),主弯为胸弯 n = 35,腰弯 n = 31)和单支具组(n = 49,8 名男性,41 名女性,年龄 14.1 ± 1.9,主弯为胸弯 n = 18,腰弯 n = 31)。每位患者均接受临床和影像学检查,并测量 Cobb 角。

结果

两种治疗方案均成功地阻止了超过 85%的病例的进展或改善了脊柱侧凸。夜间支具的初始矫正效果明显高于日间支具。然而,在 2 年的随访中,两种治疗方法的成功率无显著差异(p = 0.58)。

结论

似乎使用一种量身定制的支具治疗特发性脊柱侧凸,白天和晚上均可使用,就已足够。

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