Outcomes of bracing in juvenile idiopathic scoliosis until skeletal maturity or surgery.

Autor:	Khoshbin A; Faculty of Orthopaedic Surgery, University of Toronto †Child Health Evaluative Sciences ‡Developmental and Stem Cell Biology Program §Centre for Orthotics and Medical Devices; ¶Department of Rehabilitation Services; and ∥Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Caspi L, Law PW, Donaldson S, Stephens D, da Silva T, Bradley CS, Wright JG
Jazyk:	angličtina
Zdroj:	Spine [Spine (Phila Pa 1976)] 2015 Jan 01; Vol. 40 (1), pp. 50-5.
DOI:	10.1097/BRS.0000000000000669
Abstrakt:	Study Design: Retrospective comparative study. Objective: To evaluate the outcome of bracing in patients with juvenile idiopathic scoliosis (JIS) at either skeletal maturity or time of scoliosis surgery. Summary of Background Data: JIS is generally thought to have poor outcomes with high rates of surgical fusion. Methods: All patients with JIS between the ages of 4 and 10 years treated with a brace at the Hospital for Sick Children (SickKids) between 1989 and 2011 were eligible. Data were collected from patient health records until either 2 years after skeletal maturity or date of surgery. Results: The average age at diagnosis of 88 patients with JIS was 8.4 ± 1.4 years, with a female to male ratio of approximately 8:1. Pretreatment, Risser score was zero for 80 patients (91%); 72 (92%) of the females were premenarche; and primary Cobb angles ranged from 20° to 71°. Of the 88 patients, 60 (68%) had used a thoracolumbosacral orthosis exclusively; 28 (32%) patients used "other braces" (Milwaukee, Charleston, or a combination of braces), with an average treatment duration of 3.6 ± 1.9 years.As per Scoliosis Research Society definitions, a "non-curve-progression" (≤5° change) group consisted of 25 (28%) patients; and a "curve-progression" group consisted of 63 (72%) patients where the curve had progressed 6° or more.Of the 88 patients, 44 (50%) underwent surgery. The operative rate was higher for patients with curves 30° or more than those with curves 20° to 29° prior to brace treatment (37/58 [64%] vs. 7/30 [23%], respectively; P = 0.001); other braces compared with thoracolumbosacral orthosis (19/28 [68%] vs. 25/60 [42%], respectively; P = 0.02); Lenke I and III curves compared with Lenke VI curves (33/54 [61%] vs. 2/14 [14%], respectively; P = 0.007).
Databáze:	MEDLINE
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