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Karimi M, Nadi A. Comparative analysis of Boston and Cheneau braces in treating scoliosis: A 2-year follow-up study on curve reduction. NORTH AMERICAN SPINE SOCIETY JOURNAL 2024; 19:100337. [PMID: 39040947 PMCID: PMC11261756 DOI: 10.1016/j.xnsj.2024.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 07/24/2024]
Abstract
Background Scoliosis, characterized by the lateral curvature of the spine, impacts the spine's alignment in three dimensions. Braces are commonly employed as a conservative treatment for individuals with scoliosis, particularly those with curves ranging from 20° to 40°. This treatment approach's primary objectives include arresting the deformity's progression, enhancing clinical appearance, alleviating pain, improving overall quality of life, and circumventing the need for surgical intervention. The aim of this study was to compare the effectiveness of Boston and Cheneau braces in individuals with scoliosis. Methods In this retrospective study, 51 subjects were included and monitored over 2 years. The primary parameters under evaluation encompassed the severity of both primary and secondary curves and compliance with the prescribed treatment. The subjects were classified into 2 groups: those utilizing the Cheneau brace and those employing the Boston brace. Results The initial mean values of the primary and secondary curves during the first visit were 37.6 (±7.4) and 30.1 (±9.7) degrees, respectively. However, the in-brace curve measurements for the primary and secondary curves were 31.5 (±1.3) and 22.3 (±13.3) degrees, respectively (p-value=.0). The mean compliance values of subjects using Boston and Cheneau braces were 16.8 and 17.3 h per day, respectively (p-value=.1). No significant difference was observed in the correction achieved with the Boston and Cheneau braces during the follow-up period. Conclusions The results of this study demonstrated a significant reduction in the scoliotic curve while under brace conditions. However, the degree of correction achieved did not significantly differ during the follow-up periods. Additionally, there was no notable variance in the correction obtained between the Boston and Cheneau braces.
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Affiliation(s)
- Mohammad Karimi
- Rehabilitation Sciences, Research Center, Shiraz University of Medical sciences, Shiraz, Iran
| | - Azade Nadi
- Department of Orthotics and Prosthetics, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Lee YJ, Wang WJ, Mohamad SM, Chandren JR, Gani SMA, Chung WH, Chiu CK, Chan CYW. A comparison between Boston brace and European braces in the treatment of adolescent idiopathic scoliosis (AIS) patients: a systematic review based on the standardised Scoliosis Research Society (SRS) inclusion criteria for brace treatment. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:630-645. [PMID: 37924388 DOI: 10.1007/s00586-023-08007-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/01/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To compare the Boston brace and European braces using a standardised Scoliosis Research Society (SRS) inclusion criteria for brace treatment as well as consensus recommendations for treatment outcome. METHODS This was a systematic review that was carried out using MeSH terminology in our search protocol in PubMed, Cochrane Library, Scopus, Clinicaltrials.gov and Web of Science database between 1976 and 29th of Jan 2023. All studies that were included in this review had applied fully/partially the SRS inclusion criteria for brace wear. Outcome measures were divided into primary and secondary outcome measures. RESULTS 3830 literatures were found in which 176 literatures were deemed relevant to the study once duplicates were removed and titles and abstracts were screened. Of these literatures, only 15 had fulfilled the eligibility criteria and were included in the study. 8 of the studies were Level IV studies, 5 were Level III studies and 2 studies were Level I studies (1 prospective randomised controlled trial (RCT) and 1 Quasi-RCT). The percentage of patients who avoided surgery for European braces ranged from 88 to 100%, whereas for Boston brace ranged from 70 to 94%. When treatment success was assessed based on the final Cobb angle > 45°, approximately 15% of patients treated with European braces had treatment failure. In contrast, 20-63% of patients treated with Boston brace had curves > 45° at skeletal maturity. The BrAIST study used a cut-off point of 50° to define failure of treatment and the rate of treatment failure was 28%. Curve correction was not achieved in most patients (24-51% of patients) who were treated with the Chêneau brace and its derivatives. However, none of the patients treated with Boston brace achieved curve correction. CONCLUSION Boston brace and European braces were effective in the prevention of surgery. In addition, curve stabilisation was achieved in most studies. Limitation in current literature included lack of studies providing high level of evidence and lack of standardisation in terms of compliance to brace as well as multidisciplinary management of brace wear.
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Affiliation(s)
- Yu Jie Lee
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wee Jieh Wang
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti Mariam Mohamad
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti Mariam Abd Gani
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Weng Hong Chung
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chee Kidd Chiu
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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Asada T, Kotani T, Sakuma T, Iijima Y, Nakayama K, Inage K, Shiga Y, Akazawa T, Minami S, Ohtori S, Koda M, Yamazaki M. Impact of Brace-Related Stress on Brace Compliance in Adolescent Idiopathic Scoliosis: A Single-Center Comparative Study Using Objective Compliance Measurement and Brace-Related Stress. Spine Surg Relat Res 2023; 7:377-384. [PMID: 37636154 PMCID: PMC10447194 DOI: 10.22603/ssrr.2022-0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/15/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction This study aimed to investigate the brace compliance and clinical background of patients with adolescent idiopathic scoliosis (AIS) who demonstrate different degrees of psychological brace-related stress. Methods Forty-five patients initiating brace treatment with a Cobb angle between 25° and 45° were included. Patients receiving brace treatment for AIS were administered a questionnaire for brace-related stress (i.e., the Japanese version of the Bad Sobernheim Stress Questionnaire-Brace [JBSSQ-brace]). Based on their scores, we allocated the patients into two stress groups: mild-stress (≥16 points) and below-moderate-stress (<16 points). We investigated the character of brace compliance and brace-related psychological stress in all patients and compared the demographics and brace compliance between both groups. Results Forty-one of 45 patients completed the study. The mean JBSSQ-brace scores were 18.7±5.1, 19.1±5.2, and 18.7±5.0 points at the 1-month, 4-month, and 1-year follow-ups, respectively. There was no significant change in JBSSQ-brace scores over one year after the brace prescription (P=0.332). There was no difference in-brace compliance between seasons during the first month of brace prescription (P=0.252). Both groups' overall brace compliance was comparable (below-moderate: 17.1±7.1 h/day vs. mild: 20.4±3.0 h/day; P=0.078). The mild-stress group showed better compliance than the below-moderate-stress group on weekdays (below-moderate: 17.0±6.9 h/day vs. mild: 20.5±2.8 h/day; P=0.048) and at nighttime (below-moderate: 82.3%±27.0%/nighttime vs. mild: 93.8%±12.4%/nighttime; P=0.008). Conclusions Overall, brace compliance was comparable among patients with different brace-related stress, but brace compliance during weekdays and nighttime was significantly better in the mild-stress group.
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Affiliation(s)
- Tomoyuki Asada
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Yasushi Iijima
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Keita Nakayama
- Department of Orthopedic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Kazuhide Inage
- Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - Tsutomu Akazawa
- Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shohei Minami
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Seiji Ohtori
- Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan
| | - Masao Koda
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Lin MR, Chou PH, Huang KJ, Ting J, Liu CY, Chou WH, Lin GH, Chang JG, Ikegawa S, Wang ST, Chang WC. Whole-Exome Sequencing Identifies Genetic Variants for Severe Adolescent Idiopathic Scoliosis in a Taiwanese Population. J Pers Med 2022; 13:jpm13010032. [PMID: 36675693 PMCID: PMC9865588 DOI: 10.3390/jpm13010032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal curvature deformity that appears in the adolescent period. In this study, we performed whole-exome sequencing on 11 unrelated Taiwanese patients with a Cobb's angle greater than 40 degrees. Our results identified more than 200 potential pathogenic rare variants, however, most of which were carried only by one individual. By in silico pathogenicity annotation studies, we found that TTN, CLCN1, and SOX8 were the most important genes, as multiple pathogenic variants were within these genes. Furthermore, biological functional annotation indicated critical roles of these AIS candidate genes in the skeletal muscle. Importantly, a pathogenic variant on SOX8 was shared by over 35% of the patients. These results highlighted TTN, CLCN1, and SOX8 as the most likely susceptibility genes for severe AIS.
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Affiliation(s)
- Min-Rou Lin
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Po-Hsin Chou
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Kuei-Jung Huang
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Jafit Ting
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Chia-Ying Liu
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Wan-Hsuan Chou
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Gan-Hong Lin
- Master Program in Clinical Genomics and Proteomics, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Jan-Gowth Chang
- Center for Precision Medicine, China Medical University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Shiro Ikegawa
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Science (IMS, RIKEN), Tokyo 108-8639, Japan
| | - Shih-Tien Wang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Kinmen Hospital, Ministry of Health and Welfare, Kinmen 891, Taiwan
- Correspondence: (S.-T.W.); (W.-C.C.)
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
- Master Program in Clinical Genomics and Proteomics, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
- Integrative Research Center in Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Correspondence: (S.-T.W.); (W.-C.C.)
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Farshad M, Götschi T, Bauer DE, Böni T, Laux CJ, Kabelitz M. Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years. Spine Deform 2022; 10:1331-1338. [PMID: 35819723 PMCID: PMC9579110 DOI: 10.1007/s43390-022-00541-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) affects up to 3% of otherwise healthy adolescents. The extreme long-term outcomes of nonoperative treatment are underreported. This study aimed to investigate the long-term outcome of nonoperative-treated AIS patients. Comparison between a bracing and an observation approach were performed. METHODS In a retrospective cohort study, 20 nonoperatively treated AIS patients were observed concerning patient-related outcome measures (PROM) (visual analog scale (VAS), Short Form Health Survey 36 item (SF 36), Scoliosis Research Society (SRS 24), Oswestry Low Back Pain Disability Index (ODI), Psychological General Well-Being Index (PGWBI)), radiological curve progression and health-related quality of life (HRQoL). Baseline characteristics and radiological imaging were collected. At follow-up, anteroposterior and lateral X-rays as well as questionnaires were analyzed. RESULTS Twenty patients (16 females, mean age: 14.6 ± 3.2 years) with a follow-up time of 42 ± 9 years were included. Nine patients (initial Cobb 35° ± 19°) were treated with bracing for a mean time of 26 ± 9 months, while the other 11 patients (initial Cobb 29° ± 11°) were observed. The primary curve progressed from 32° ± 15° to 52° ± 25° in average with no significant difference between the cohorts (p = 0.371). At final follow-up, a mean ODI score of 7 ± 7.9 points with no difference depending on the treatment (p = 0.668) was seen. No significant differences were observed for PROMs. Curve magnitude correlated neither at diagnosis (p = 0.617) nor at follow-up (p = 0.535) with the ODI score at final follow-up. CONCLUSION After a mean of 42 years, patients with nonoperative treatment of moderate AIS demonstrated a good clinical outcome despite progression of the deformity. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Mazda Farshad
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Tobias Götschi
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, 8008 Zurich, Switzerland
| | - David E. Bauer
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Thomas Böni
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Christoph J. Laux
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
| | - Method Kabelitz
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland
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Brace and Physiotherapeutic Scoliosis Specific Exercises (PSSE) for Adolescent Idiopathic Scoliosis (AIS) treatment: a prospective study following Scoliosis Research Society (SRS) criteria. Arch Physiother 2022; 12:22. [PMID: 36316760 PMCID: PMC9624025 DOI: 10.1186/s40945-022-00150-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A growing scientific evidence for conservative treatment of AIS has recently proved that bracing is superior to natural history. Our aim was to investigate the effectiveness of a combined treatment with brace and PSSE for AIS. METHODS Prospective study, following SRS research inclusion criteria (> 10 years, 25ο - 40ο, Risser 0-2, < 1-year post-menarche, no prior treatment). 102 consecutive patients (87 females-15 males, mean age 12.8 years, Risser 0.48, Cobb Thoracic 29.2ο, Lumbar 27.8ο) received treatment with Cheneau brace and PSSE. Average follow-up time was 26.4 months. A scale from A to C was used to evaluate compliance with brace and PSSE (A: full-compliant, B: partially compliant, C: non-compliant). 7 subjects dropped-out (6.8%), so finally 95 patients included for statistical analysis, using paired t-test. RESULTS Sixty-two patients (65.3%) remained stable, 22 improved > 5ο (23.2%) and 11 progressed (11.5%). In-brace correction (IBC) was 49.7% for thoracic and 61.7% for lumbar curves. Analysis of progressed cases revealed that IBC (31.7% for thoracic and 34.4% for lumbar curves) and compliance (81.8% C for brace, 63.6% C for PSSE) was lower than average. Group A for treatment compliance (65.3%), showed significantly better results (70.9% stable, 29.1% improved, 0% progressed). CONCLUSION A combination of bracing and PSSE can effectively treat AIS, according to SRS inclusion criteria. 88.5% of patients avoided progression > 5ο and only 6.4% overpassed 40ο. IBC and compliance are the most important prognostic factors for successful treatment result. Early detection of AIS is also necessary for increased possibilities of effective conservative treatment.
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Li K, Ma G, Zhao H, Han Y, Zuo J, Miao J, Zhang J, Wang X. Effects of bracing on pelvic parameters in adolescent idiopathic scoliosis: A retrospective study. Medicine (Baltimore) 2022; 101:e30015. [PMID: 36042667 PMCID: PMC9410678 DOI: 10.1097/md.0000000000030015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To evaluate the effects of Chêneau bracing on Cobb's angle (CA) and spinopelvic parameters in adolescent idiopathic scoliosis (AIS) patients. In this retrospective study, we evaluated 51 AIS patients who received Chêneau bracing treatment between January 2020 and August 2021. The prebracing and in-bracing radiographs were analyzed about the spinopelvic parameters. The CA, pelvic coronal obliquity angle, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical angle, and coronal vertical angle were measured. Paired t-test was used to compare prebracing and in-bracing spinopelvic parameters. The Pearson correlation analysis was used to identify the relationships between the variations in the spinopelvic parameters. The mean age at the initiation of bracing was 13.6 ± 1.5 years. The mean prebracing CA was 24.0° ± 6.3°. There were no statistically significant differences between prebracing and in-bracing measurements of sagittal and coronal vertical angles. However, there were statistically significant differences between the prebracing and in-bracing measurements of the CA, pelvic coronal obliquity angle, TLK, LL, PT, and SS. A significant correlation was observed between PT and thoracolumbar kyphosis variations in the sagittal plane. The pelvic coronal obliquity angle variation was correlated to the prebracing pelvic coronal obliquity angle in the coronal plane. Chêneau's bracing effects of AIS can be extended to the pelvis. Affected by the Chêneau brace, the pelvis should be retro-rotated correspondingly to TLK hyperkyphosis on the sagittal plane, whereas in the coronal plane, pelvic obliquity was improved independently. The effect of Chêneau braces on the pelvic parameters should be fully considered before bracing treatment.
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Affiliation(s)
- Kepeng Li
- Second Central Hospital of Baoding, Zhuozhou City, Hebei, China
| | - Guoju Ma
- Second Central Hospital of Baoding, Zhuozhou City, Hebei, China
- *Correspondence: Guoju Ma, Second Central Hospital of Baoding, 57 Fanyang Middle Road, Zhuozhou City, Hebei, China (e-mail: )
| | - Heyi Zhao
- Second Central Hospital of Baoding, Zhuozhou City, Hebei, China
| | - Ye Han
- The Affiliated Hospital of Hebei University, Baoding City, Hebei, China
| | - Jinzeng Zuo
- Tangshan Second Hospital, Lubei District, Tangshan City, Hebei, China
| | - Jun Miao
- Tianjin Hospital, Hexi District, Tianjin, China
| | | | - Xijie Wang
- Tianjin Hospital, Hexi District, Tianjin, China
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Galbusera F, Bassani T, Panico M, Sconfienza LM, Cina A. A fresh look at spinal alignment and deformities: Automated analysis of a large database of 9832 biplanar radiographs. Front Bioeng Biotechnol 2022; 10:863054. [PMID: 35910028 PMCID: PMC9335010 DOI: 10.3389/fbioe.2022.863054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
We developed and used a deep learning tool to process biplanar radiographs of 9,832 non-surgical patients suffering from spinal deformities, with the aim of reporting the statistical distribution of radiological parameters describing the spinal shape and the correlations and interdependencies between them. An existing tool able to automatically perform a three-dimensional reconstruction of the thoracolumbar spine has been improved and used to analyze a large set of biplanar radiographs of the trunk. For all patients, the following parameters were calculated: spinopelvic parameters; lumbar lordosis; mismatch between pelvic incidence and lumbar lordosis; thoracic kyphosis; maximal coronal Cobb angle; sagittal vertical axis; T1-pelvic angle; maximal vertebral rotation in the transverse plane. The radiological parameters describing the sagittal alignment were found to be highly interrelated with each other, as well as dependent on age, while sex had relatively minor but statistically significant importance. Lumbar lordosis was associated with thoracic kyphosis, pelvic incidence and sagittal vertical axis. The pelvic incidence-lumbar lordosis mismatch was found to be dependent on the pelvic incidence and on age. Scoliosis had a distinct association with the sagittal alignment in adolescent and adult subjects. The deep learning-based tool allowed for the analysis of a large imaging database which would not be reasonably feasible if performed by human operators. The large set of results will be valuable to trigger new research questions in the field of spinal deformities, as well as to challenge the current knowledge.
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Affiliation(s)
- Fabio Galbusera
- Spine Center, Schulthess Clinic, Zurich, Switzerland
- *Correspondence: Fabio Galbusera,
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Matteo Panico
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Andrea Cina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Putra RAC, Limskul D, Yotnuengnit P, Promsang T, Kuptniratsaikul S. Evaluation of In-brace Correction in Individuals with Adolescent Idiopathic Scoliosis: A Retrospective and Descriptive Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introductions: Achieving maximum correction at the beginning of brace treatment in AIS is the only factor that can be controlled by the bracing provider if we have a better understanding of the prognostics and factors associated with achieving in-brace correction. The aim of this present study was to evaluate in-brace correction in a cohort of AIS patients who were treated by full-time bracing with plastic moulded thoraco-lumbo-sacral spinal orthosis (TLSO).
Methods: This study was a retrospective descriptive study. We collected data from medical records of individuals with AIS who receiving full-time braces treatment from Orthotic Clinic, King Chulalongkorn Memorial Hospital. Demographic data included age, gender, weight, height, and body mass index (BMI). Cobb angle, Risser sign, and curve type were determined using pre and post-brace standing posteroanterior (PA) radiographs. Correlation analysis was performed to investigate in-brace correction with associated factors.
Results: We included 91 patients' data and radiographic images with AIS, with seven (7.69%) boys and 84 (92.31%). The overall mean Cobb angle was 32.9 ± 8.5º, and during brace treatment, it was 22.5 ± 11.5º. There was a significant mean difference in the mean Cobb angle before and in-brace (p < 0.001). The overall mean in-brace correction in the study was 34.1 ± 22.7%. Initial Cobb angle and BMI were found to be significantly negatively associated with in-brace correction with a Pearson coefficient of -0.49 and -0.24, respectively.
Conclusion: The mean of first in-brace correction TLSO was 34.1% from the initial Cobb angle. No difference in in-brace correction across curve types in our study. There was a significant Cobb angle changed before and in-brace radiograph. We found that in-brace correction was significantly associated with initial Cobb angle and BMI.
Keywords: Adolescent Idiopathic Scoliosis, in-brace correction, bracing
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Gámiz-Bermúdez F, Obrero-Gaitán E, Zagalaz-Anula N, Lomas-Vega R. Corrective exercise-based therapy for adolescent idiopathic scoliosis: Systematic review and meta-analysis. Clin Rehabil 2021; 36:597-608. [PMID: 34962437 DOI: 10.1177/02692155211070452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE to analyze the efficacy of Corrective exercise-based therapy in the improvement of deformity and quality of life in adolescent idiopathic scoliosis. DATA SOURCES PubMed Medline, Scopus, Web of Science (WOS), Physiotherapy Evidence Database, CINAHL Complete and SciELO, until June 2021. REVIEW METHODS Randomized controlled trials was selected, including participants diagnosed with adolescent idiopathic scoliosis, in which the experimental group received Corrective exercise-based therapy. Two authors independently searched the scientific literature in the data sources, extracted the data and assessed the risk of bias. A pairwise meta-analysis using the random-effects model was performed. RESULTS Eight randomized controlled trials providing data from 279 adolescent idiopathic scoliosis patients were included. Seven randomized controlled trials including 236 patients showed moderate-quality evidence for a medium effect (SMD = -0.52, 95% CI -0.96 to -0.1), favoring corrective exercise-based therapy for spinal deformity reduction. Corrective exercise-based therapy was better than no intervention (SMD = -0.59, 95% CI -1.18 to -0.01) but similar to other intervention (SMD = -0.2, 95% CI -0.67 to 0.27), and a medium effect was found (SMD = -0.51, 95% CI -0.89 to -0.13) when corrective exercise-based therapy was used with other therapies. Four studies including 151 patients showed low-quality evidence of a large effect of Corrective exercise-based therapy on Scoliosis Research Society measurement (SRS-22) total score improvement (SMD = 1.16, 95% CI 0.36 to 1.95). CONCLUSION In mild and moderate adolescent idiopathic scoliosis patients, corrective exercise-based therapy could be used to reduce spinal deformity and to improve quality of life as isolated treatment or as coadjuvant treatment combined with other therapeutic resources.
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Ali A, Fontanari V, Fontana M, Schmölz W. Spinal Deformities and Advancement in Corrective Orthoses. Bioengineering (Basel) 2020; 8:2. [PMID: 33375594 PMCID: PMC7824216 DOI: 10.3390/bioengineering8010002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/04/2022] Open
Abstract
Spinal deformity is an abnormality in the spinal curves and can seriously affect the activities of daily life. The conventional way to treat spinal deformities, such as scoliosis, kyphosis, and spondylolisthesis, is to use spinal orthoses (braces). Braces have been used for centuries to apply corrective forces to the spine to treat spinal deformities or to stabilize the spine during postoperative rehabilitation. Braces have not modernized with advancements in technology, and very few braces are equipped with smart sensory design and active actuation. There is a need to enable the orthotists, ergonomics practitioners, and developers to incorporate new technologies into the passive field of bracing. This article presents a review of the conventional passive braces and highlights the advancements in spinal orthoses in terms of improved sensory designs, active actuation mechanisms, and new construction methods (CAD/CAM, three-dimensional (3D) printing). This review includes 26 spinal orthoses, comprised of passive rigid/soft braces, active dynamics braces, and torso training devices for the rehabilitation of the spine.
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Affiliation(s)
- Athar Ali
- Department of Industrial Engineering, University of Trento, 38122 Trento, Italy; (V.F.); (M.F.)
| | - Vigilio Fontanari
- Department of Industrial Engineering, University of Trento, 38122 Trento, Italy; (V.F.); (M.F.)
| | - Marco Fontana
- Department of Industrial Engineering, University of Trento, 38122 Trento, Italy; (V.F.); (M.F.)
| | - Werner Schmölz
- Department of Trauma Surgery, Medizinische Universität Innsbruck, 6020 Innsbruck, Austria;
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Karavidas N. Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2019; 10:153-172. [PMID: 31632169 PMCID: PMC6790111 DOI: 10.2147/ahmt.s190565] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022]
Abstract
Brace effectiveness for adolescent idiopathic scoliosis was controversial until recent studies provided high quality of evidence that bracing can decrease likelihood of progression and need for operative treatment. Very low evidence exists regarding bracing over 40ο and adult degenerative scoliosis. Initial in-brace correction and compliance seem to be the most important predictive factors for successful treatment outcome. However, the amount of correction and adherence to wearing hours have not been established yet. Moderate evidence suggests that thoracic and double curves, and curves over 30ο at an early growth stage have more risk for failure. High and low body mass index scores are also associated with low successful rates. CAD/CAM braces have shown better initial correction and are more comfortable than conventional plaster cast braces. For a curve at high risk of progression, rigid and day-time braces are significantly more effective than soft or night-time braces. No safe conclusion on effectiveness can be drawn while comparing symmetrical and asymmetrical brace designs. The addition of physiotherapeutic scoliosis-specific exercises in brace treatment can provide better outcomes and is recommended, when possible. Despite the growing evidence for brace effectiveness, there is still an imperative need for future high methodological quality studies to be conducted.
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Affiliation(s)
- Nikos Karavidas
- Schroth Scoliosis & Spine Clinic, Physiotherapy Department, Athens, Greece
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