Lau Rufina Wing-Lum, Hung Alec Lik-Hang, Kee Ho-Man, Wong Leo Chung-Hei, Chan Victor Kin-Wai, Chung Derek Wai-Yin, Chan Jerry Kwok-To, Chau Bosco Kin-Pok, Leung Stanley Ho-Fung, Cheng Jack Chun-Yiu, Lam Tsz-Ping, Lau Adam Yiu-Chung
School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China.
SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Clin Med. 2024 Jan 29;13(3):767. doi: 10.3390/jcm13030767.
: Bracing is one of the first-line treatment for early-onset idiopathic scoliosis (EOIS) to control curves from progression. This study aimed to explore the determinants that govern bracing effectiveness in EOIS. : One hundred and eleven patients with EOIS (mean age of 8.6 ± 1.25 at diagnosis) received bracing treatment and had a final follow-up beyond skeletal maturity were identified from records between 1988 and 2021. Demographic data and clinical features of spinal curvature were obtained for correlation analyses to determine the associations between curve outcomes and clinical features. : Most patients were female (85.6%) and had a major curve on the left side (67%). The mean baseline Cobb angle of major curves was 21.73 ± 7.92°, with a mean Cobb angle progression of 18.05 ± 19.11°. The average bracing duration was 5.3 ± 1.9 years. Only 26 (23.4%) of them underwent surgery. The final Cobb angle and curve progression at the final follow-up with a Cobb angle of ≥50° were positively correlated with the initial Cobb angle (r = 0.206 and r = 0.313, respectively) and negatively correlated with maturity parameters. The lumbar curve type was found to correlate with a smaller final Cobb angle. : The majority of patients had a final Cobb angle < 50°, which was considered a successful bracing outcome. The final Cobb angle correlated with the initial Cobb angle and curve types observed in EOIS.
支具治疗是早发性特发性脊柱侧凸（EOIS）控制侧弯进展的一线治疗方法之一。本研究旨在探讨影响EOIS支具治疗效果的决定因素。111例EOIS患者（诊断时平均年龄8.6±1.25岁）接受了支具治疗，并从1988年至2021年的记录中确定了在骨骼成熟后进行了最终随访的患者。获取人口统计学数据和脊柱侧凸的临床特征进行相关性分析，以确定侧弯结局与临床特征之间的关联。大多数患者为女性（85.6%），主要侧弯在左侧（67%）。主要侧弯的平均基线Cobb角为21.73±7.92°，平均Cobb角进展为18.05±19.11°。平均支具佩戴时间为5.3±1.9年。其中只有26例（23.4%）接受了手术。最终随访时Cobb角≥50°的最终Cobb角和侧弯进展与初始Cobb角呈正相关（分别为r = 0.206和r = 0.313），与成熟参数呈负相关。发现腰椎侧弯类型与较小的最终Cobb角相关。大多数患者的最终Cobb角<50°，这被认为是支具治疗的成功结果。最终Cobb角与EOIS中观察到的初始Cobb角和侧弯类型相关。
