Nachemson A L, Peterson L E
Department of Orthopaedics, Göteborg University, Sweden.
J Bone Joint Surg Am. 1995 Jun;77(6):815-22. doi: 10.2106/00004623-199506000-00001.
In a prospective study by the Scoliosis Research Society, 286 girls who had adolescent idiopathic scoliosis, a thoracic or thoracolumbar curve of 25 to 35 degrees, and a mean age of twelve years and seven months (range, ten to fifteen years) were followed to determine the effect of treatment with observation only (129 patients), an underarm plastic brace (111 patients), and nighttime surface electrical stimulation (forty-six patients). Thirty-nine patients were lost to follow-up, leaving 247 (86 per cent) who were followed until maturity or who were dropped from the study because of failure of the assigned treatment. The end point of failure of treatment was defined as an increase in the curve of at least 6 degrees, from the time of the first roentgenogram, on two consecutive roentgenograms. As determined with use of this end point, treatment with a brace failed in seventeen of the 111 patients; observation only, in fifty-eight of the 129 patients; and electrical stimulation, in twenty-two of the forty-six patients. According to survivorship analysis, treatment with a brace was associated with a success rate of 74 per cent (95 per cent confidence interval, 52 to 84) at four years; observation only, with a success rate of 34 per cent (95 per cent confidence interval, 16 to 49); and electrical stimulation, with a success rate of 33 per cent (95 per cent confidence interval, 12 to 60).(ABSTRACT TRUNCATED AT 250 WORDS)
在脊柱侧弯研究协会的一项前瞻性研究中,对286名患有青少年特发性脊柱侧弯的女孩进行了跟踪,她们的胸段或胸腰段侧弯角度为25至35度,平均年龄为12岁7个月(范围为10至15岁),以确定仅观察(129例患者)、腋下塑料支具(111例患者)和夜间表面电刺激(46例患者)这三种治疗方法的效果。39例患者失访,剩下247例(86%)患者被跟踪至成熟或因指定治疗失败而退出研究。治疗失败的终点定义为从首次X线片时起,连续两张X线片上侧弯至少增加6度。根据这个终点确定,111例使用支具治疗的患者中有17例失败;129例仅观察的患者中有58例失败;46例接受电刺激治疗的患者中有22例失败。根据生存分析,使用支具治疗在四年时的成功率为74%(95%置信区间为52至84);仅观察的成功率为34%(95%置信区间为16至49);电刺激的成功率为33%(95%置信区间为12至60)。(摘要截短至250字)