Pepke Wojciech, Morani William, Schiltenwolf Marcus, Bruckner Tom, Renkawitz Tobias, Hemmer Stefan, Akbar Michael
Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, 69120 Heidelberg, Germany.
J Clin Med. 2023 Mar 26;12(7):2507. doi: 10.3390/jcm12072507.
Chêneau-brace (C-Brace) is a potential tool for the treatment of adolescent idiopathic scoliosis (AIS) with a Cobb angle between 20° and 45° for the primary curve. The aim of the present study was (1) to estimate study cohorts with C-brace therapy success and therapy failure and (2) to analyze possible factors that influence the therapy outcome. Seventy-eight patients with AIS were assessed before the initiation of C-brace treatment. Each patient underwent radiography examinations before the brace, in-brace, and at the therapy end. Cobb angle was considered as increased when the value at the end of therapy was increased more than 5° (Δ > 5°), unchanged-when the value was unchanged within ± 5° and decreased- when the value was decreased more than 5° (Δ < -5°). The study cohort was stratified due to curve topography in the thoracic, thoracolumbar, and lumbar scoliosis groups. Global analysis revealed no statistically significant modification of the Cobb angle (Cobb angle pre-brace vs. Cobb angle post-brace: 30.8° ± 8.2 vs. 29.3° ± 15.2, = 0.26). However, at the end of C-brace therapy, the primary Cobb angle was decreased by more than 5° in 27 patients (35%), unchanged (Δ within the range of ±5°) in 36 patients (46%), and increased more than 5° in 15 patients (19%). Sub-group analysis due to curve topography and skeletal maturity has shown higher rates of brace therapy failure in thoracic curves and in younger patients (Risser grade 0). Patients with higher Cobb angle correction with C-brace had lower rates of therapy failure. The C-brace can be useful for the prevention of scoliotic curve progression in patients with AIS. However, many factors influence the therapy effect.
谢诺支具（C型支具）是治疗青少年特发性脊柱侧凸（AIS）主弯Cobb角在20°至45°之间的一种潜在工具。本研究的目的是（1）评估C型支具治疗成功和治疗失败的研究队列，以及（2）分析影响治疗结果的可能因素。78例AIS患者在开始C型支具治疗前接受评估。每位患者在佩戴支具前、佩戴支具期间和治疗结束时均接受了X线检查。当治疗结束时的值增加超过5°（Δ>5°）时，Cobb角被认为增大；当值在±5°范围内不变时，Cobb角被认为不变；当值减小超过5°（Δ<-5°）时，Cobb角被认为减小。研究队列根据胸段、胸腰段和腰段脊柱侧凸组的曲线形态进行分层。整体分析显示Cobb角无统计学意义的改变（佩戴支具前Cobb角与佩戴支具后Cobb角：30.8°±8.2 vs. 29.3°±15.2，P = 0.26）。然而，在C型支具治疗结束时，27例患者（35%）的主Cobb角减小超过5°，36例患者（46%）不变（Δ在±5°范围内），15例患者（19%）增大超过5°。根据曲线形态和骨骼成熟度进行的亚组分析显示，胸段曲线和年轻患者（Risser分级0级）的支具治疗失败率较高。C型支具矫正Cobb角较高的患者治疗失败率较低。C型支具可用于预防AIS患者脊柱侧凸曲线进展。然而，许多因素会影响治疗效果。
