基于支具佩戴依从性的青少年特发性脊柱侧凸夜间支具治疗的结果。

Outcomes for nighttime bracing in adolescent idiopathic scoliosis based on brace wear adherence.

机构信息

Scottish Rite for Children, 2222 Welborn Street, Dallas, TX, 75219, USA.

Shriners Children's Spokane, Spokane, WA, USA.

出版信息

Spine Deform. 2024 May;12(3):643-650. doi: 10.1007/s43390-024-00835-w. Epub 2024 Mar 8.

DOI:10.1007/s43390-024-00835-w

PMID:38457029

Abstract

BACKGROUND

This study determined brace wear adherence for patients treated with nighttime braces and evaluated the effect of brace adherence on curve progression.

METHODS

One hundred twenty-two patients with AIS ages 10-16 years, Risser stages 0-2, major curves 20°-40° treated with Providence nighttime braces prescribed to be worn at least 8 h per night were prospectively enrolled and followed until skeletal maturity or surgery. Brace adherence was measured using iButton temperature sensors after 3 months of brace initiation and at brace discharge.

RESULTS

Curve types were single thoracolumbar/lumbar (62%, n = 76), double (36%, n = 44), and single thoracic (2%, n = 2). Brace adherence averaged 7.8 ± 2.3 h after 3 months (98% adherence) and 6.7 ± 2.6 h at brace discharge (84% adherence). Curves that progressed ≥ 6° had decreased brace adherence than non-progressive curves after 3 months (7.0 h vs. 8.1 h, p = 0.010) and at brace discharge (5.9 h vs. 7.1 h, p = 0.017). Multivariate logistic regression analysis showed that increased hours of brace wear [odds ratio (OR) 1.23, 95% confidence interval (CI) 1.06-1.46], single curves (OR 3.11, 95% CI 1.35-7.53), and curves < 25° (OR 2.61, 95% CI 1.12-6.44) were associated with non-progression at brace discharge.

CONCLUSIONS

Patients treated with nighttime bracing have a high rate of brace adherence. Lack of curve progression is associated with increased brace wear. Nighttime bracing is effective at limiting curve progression in AIS single thoracolumbar/lumbar and double curves.

LEVEL OF EVIDENCE

Prognostic Level 2.

摘要

背景

本研究确定了夜间支具治疗的患者的支具佩戴依从性，并评估了支具佩戴依从性对曲线进展的影响。

方法

122 名年龄在 10-16 岁、Risser 分期 0-2、主曲线为 20°-40°的 AIS 患者，采用 Providence 夜间支具治疗，建议每晚佩戴至少 8 小时，前瞻性入组并随访至骨骼成熟或手术。支具佩戴依从性使用 iButton 温度传感器在支具佩戴 3 个月后和支具去除时进行测量。

结果

曲线类型为单胸腰椎/腰椎（62%，n=76）、双胸腰椎（36%，n=44）和单胸（2%，n=2）。支具佩戴依从性在 3 个月后平均为 7.8±2.3 小时（98%的依从性），在支具去除时为 6.7±2.6 小时（84%的依从性）。进展≥6°的曲线在 3 个月后（7.0 小时比 8.1 小时，p=0.010）和支具去除时（5.9 小时比 7.1 小时，p=0.017）的支具佩戴依从性均低于无进展曲线。多变量逻辑回归分析表明，增加支具佩戴时间[比值比（OR）1.23，95%置信区间（CI）1.06-1.46]、单曲线（OR 3.11，95%CI 1.35-7.53）和<25°的曲线（OR 2.61，95%CI 1.12-6.44）与支具去除时无进展相关。