Allington N J, Bowen J R
Alfred I. duPont Institute, Wilmington, Delaware 19899, USA.
J Bone Joint Surg Am. 1996 Jul;78(7):1056-62.
We reviewed the clinical records and the radiographs of 188 patients who had adolescent idiopathic scoliosis. Our purpose was to determine whether part-time and full-time bracing had been equally effective in preventing progression of the curve. Full-time bracing had been used for ninety-eight patients; part-time bracing, for forty-nine; and electrical stimulation, for forty-one. Eighty-eight patients had had a curve of less than 30 degrees and 100 patients, a curve of 30 to 40 degrees. The treatment was considered a failure if the curve had increased 5 degrees or more. The curve progressed 5 degrees or more in thirteen (36 per cent) of the thirty-six patients who had had full-time bracing for a curve of less than 30 degrees, in thirteen (41 per cent) of the thirty-two who had had part-time bracing for such a curve, and in fourteen (70 per cent) of the twenty who had had electrical stimulation for such a curve. Compared with electrical stimulation, both full-time and part-time bracing prevented progression significantly more effectively (p < 0.02 and p < 0.04, respectively). With the numbers available, the difference in progression between the groups that had had full-time and parttime bracing was not significant (p < 0.18). The curve progressed 5 degrees or more in thirty-six (58 per cent) of the sixty-two patients who had had full-time bracing for a curve of 30 to 40 degrees, in ten of the seventeen who had had part-time bracing for such a curve, and in eighteen (86 per cent) of the twenty-one who had had electrical stimulation for such a curve. The difference in progression between each bracing program and electrical stimulation was significant (p < 0.03 for the full-time program and p < 0.05 for the part-time program). With the numbers available, the difference in progression between full-time and part-time bracing was not significant (p < 1.14).
我们回顾了188例青少年特发性脊柱侧凸患者的临床记录和X光片。我们的目的是确定兼职支具和全职支具在预防侧弯进展方面是否同样有效。98例患者使用全职支具；49例使用兼职支具；41例使用电刺激。88例患者侧弯小于30度，100例患者侧弯为30至40度。如果侧弯增加5度或更多，则治疗被视为失败。对于侧弯小于30度且接受全职支具治疗的36例患者中，有13例（36%）侧弯进展5度或更多；对于此类侧弯接受兼职支具治疗的32例患者中，有13例（41%）侧弯进展5度或更多；对于此类侧弯接受电刺激治疗的20例患者中，有14例（70%）侧弯进展5度或更多。与电刺激相比，全职和兼职支具预防进展的效果均显著更优（分别为p < 0.02和p < 0.04）。就现有数据而言，接受全职和兼职支具治疗的组之间在进展方面的差异不显著（p < 0.18）。对于侧弯为30至40度且接受全职支具治疗的62例患者中，有36例（58%）侧弯进展5度或更多；对于此类侧弯接受兼职支具治疗的17例患者中有10例侧弯进展5度或更多；对于此类侧弯接受电刺激治疗的21例患者中有18例（86%）侧弯进展5度或更多。每个支具治疗方案与电刺激在进展方面的差异均显著（全职方案为p < 0.03，兼职方案为p < 0.05）。就现有数据而言，全职和兼职支具在进展方面的差异不显著（p < 1.14）。
