{Reference Type}: Journal Article
{Title}: Improvement in axial rotation with bracing reduces the risk of curve progression in patients with adolescent idiopathic scoliosis.
{Author}: Fields MW;Rymond CC;Malka MS;Givens RR;Simhon ME;Matsumoto H;Marciano GF;Boby AZ;Roye BD;Vitale MG;
{Journal}: Spine Deform
{Volume}: 0
{Issue}: 0
{Year}: 2024 May 2
暂无{DOI}: 10.1007/s43390-024-00888-x
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.<BR><B>METHODS: </B>Retrospective study; Level III.