Abstract：
OBJECTIVE: New evidence highlights the significance of 3D in-brace correction for Adolescent Idiopathic Scoliosis (AIS) patients. This study explores how axial parameters relate to treatment failure in braced AIS patients.
METHODS: AIS patients (Sanders 1-5) undergoing Rigo-Chêneau bracing at a single institution were included. Axial vertebral rotation (AVR) was determined by utilizing pre-brace and in-brace 3D reconstructions from EOS® radiographs. The primary outcome was treatment failure: surgery or coronal curve progression > 5°. Minimum follow-up was two years.
RESULTS: 75 patients (81% female) were included. Mean age at bracing initiation was 12.8 ± 1.3 years and patients had a pre-brace major curve of 31.0° ± 6.5°. 25 patients (76% female) experienced curve progression > 5°, and 18/25 required surgical intervention. The treatment failure group had larger in-brace AVR than the success group (5.8° ± 4.1° vs. 9.9° ± 7.6°, p = 0.003), but also larger initial coronal curve measures. In-brace AVR did not appear to be associated with treatment failure after adjusting for the pre-brace major curve (Hazard Ratio (HR):0.99, 95% Confidence Interval (CI):0.94-1.05, p = 0.833). Adjusting for pre-brace major curve, patients with AVR improvement with bracing had an 85% risk reduction in treatment failure versus those without (HR:0.15, 95% CI:0.02-1.13, p = 0.066). At the final follow-up, 42/50 (84%) patients without progression had Sanders ≥ 7.
CONCLUSIONS: While in-brace rotation was not an independent predictor of curve progression (due to its correlation with curve magnitude), improved AVR with bracing was a significant predictor of curve progression. This study is the first step toward investigating the interplay between 3D parameters, skeletal maturity, compliance, and brace efficacy, allowing a future prospective multicenter study.
METHODS: Retrospective study; Level III.
METHODS: AIS patients (Sanders 1-5) undergoing Rigo-Chêneau bracing at a single institution were included. Axial vertebral rotation (AVR) was determined by utilizing pre-brace and in-brace 3D reconstructions from EOS® radiographs. The primary outcome was treatment failure: surgery or coronal curve progression > 5°. Minimum follow-up was two years.
RESULTS: 75 patients (81% female) were included. Mean age at bracing initiation was 12.8 ± 1.3 years and patients had a pre-brace major curve of 31.0° ± 6.5°. 25 patients (76% female) experienced curve progression > 5°, and 18/25 required surgical intervention. The treatment failure group had larger in-brace AVR than the success group (5.8° ± 4.1° vs. 9.9° ± 7.6°, p = 0.003), but also larger initial coronal curve measures. In-brace AVR did not appear to be associated with treatment failure after adjusting for the pre-brace major curve (Hazard Ratio (HR):0.99, 95% Confidence Interval (CI):0.94-1.05, p = 0.833). Adjusting for pre-brace major curve, patients with AVR improvement with bracing had an 85% risk reduction in treatment failure versus those without (HR:0.15, 95% CI:0.02-1.13, p = 0.066). At the final follow-up, 42/50 (84%) patients without progression had Sanders ≥ 7.
CONCLUSIONS: While in-brace rotation was not an independent predictor of curve progression (due to its correlation with curve magnitude), improved AVR with bracing was a significant predictor of curve progression. This study is the first step toward investigating the interplay between 3D parameters, skeletal maturity, compliance, and brace efficacy, allowing a future prospective multicenter study.
METHODS: Retrospective study; Level III.
摘要：
目的：新证据强调了3D支架矫正对青少年特发性脊柱侧凸（AIS）患者的重要性。这项研究探讨了轴向参数与支撑AIS患者治疗失败的关系。
方法：AIS患者（Sanders1-5）在单一机构接受Rigo-Chäneau支架。通过利用EOS®射线照片的预支架和支架内3D重建来确定轴向椎骨旋转（AVR）。主要结果是治疗失败：手术或冠状曲线进展>5°。至少随访两年。
结果：纳入75例患者（81%为女性）。开始支撑的平均年龄为12.8±1.3岁，患者的支撑前主曲线为31.0°±6.5°。25例患者（76%为女性）曲线进展>5°，18/25需要手术干预。治疗失败组的支架内AVR大于成功组（5.8°±4.1°vs.9.9°±7.6°,p=0.003),但也有较大的初始日冕曲线测量。在调整支架前主要曲线后，支架内AVR似乎与治疗失败无关（危险比（HR）：0.99，95％置信区间（CI）：0.94-1.05，p=0.833）。调整预支撑主曲线，与无支撑的患者相比,AVR改善的患者治疗失败风险降低了85%(HR:0.15,95%CI:0.02-1.13,p=0.066).在最后的后续行动中，42/50（84%）无进展的患者桑德斯≥7。
结论：虽然内支旋转不是曲线进展的独立预测因子（由于其与曲线大小的相关性），使用支撑改善AVR是曲线进展的重要预测因子。这项研究是研究3D参数之间相互作用的第一步，骨骼成熟度,合规,和支撑功效，允许未来的前瞻性多中心研究。
方法：回顾性研究；III级。
方法：AIS患者（Sanders1-5）在单一机构接受Rigo-Chäneau支架。通过利用EOS®射线照片的预支架和支架内3D重建来确定轴向椎骨旋转（AVR）。主要结果是治疗失败：手术或冠状曲线进展>5°。至少随访两年。
结果：纳入75例患者（81%为女性）。开始支撑的平均年龄为12.8±1.3岁，患者的支撑前主曲线为31.0°±6.5°。25例患者（76%为女性）曲线进展>5°，18/25需要手术干预。治疗失败组的支架内AVR大于成功组（5.8°±4.1°vs.9.9°±7.6°,p=0.003),但也有较大的初始日冕曲线测量。在调整支架前主要曲线后，支架内AVR似乎与治疗失败无关（危险比（HR）：0.99，95％置信区间（CI）：0.94-1.05，p=0.833）。调整预支撑主曲线，与无支撑的患者相比,AVR改善的患者治疗失败风险降低了85%(HR:0.15,95%CI:0.02-1.13,p=0.066).在最后的后续行动中，42/50（84%）无进展的患者桑德斯≥7。
结论：虽然内支旋转不是曲线进展的独立预测因子（由于其与曲线大小的相关性），使用支撑改善AVR是曲线进展的重要预测因子。这项研究是研究3D参数之间相互作用的第一步，骨骼成熟度,合规,和支撑功效，允许未来的前瞻性多中心研究。
方法：回顾性研究；III级。
