L A Karol1. 1. Department of Orthopaedics, Texas Scottish Rite Hospital for Children, Dallas, Texas 75219, USA. lkarol1@airmail.net
Abstract
STUDY DESIGN: A review of a clinical series was performed. OBJECTIVE: To assess the effectiveness of orthotic treatment in male patients with idiopathic scoliosis and to compare with published data on female patients. SUMMARY OF BACKGROUND DATA: Although males have been included in bracing studies, the number of males has been small, and there have been no studies of exclusively male braced patients. METHODS: The medical records of 112 males with idiopathic scoliosis age > or =10 years who were prescribed orthoses were reviewed to confirm idiopathic etiology, determine the brace prescribed, and estimate compliance. Cobb angles and Risser signs were measured from radiographs at presentation, brace prescription, brace discontinuation, and final follow-up. Progression was defined as an increase in curve magnitude of 6 degrees. Surgical progression was defined as progression to 50 degrees and/or arthrodesis. The average age at brace prescription was 13.9 years, and 66% were Risser 0. Duration of treatment averaged 3.1 years. Curve magnitude at brace prescription averaged 33.1 degrees. The patients were observed an average of 1.2 years after the brace was discontinued. RESULTS: Progression of 6 degrees occurred in 74% of boys, and 46% reached surgical thresholds. Curve progression was related to immature Risser status but not to age or curve magnitude. Progression to surgery was related to immature Risser status and initial curve magnitude. Curves measuring > or =30 degrees progressed to surgical magnitudes in >50% of patients. Compliance was good in only 38% of patients. CONCLUSIONS: Bracing of male patients with idiopathic scoliosis is ineffective. Curves measuring > or =30 degrees are very likely to progress to surgery, especially in immature patients.
STUDY DESIGN: A review of a clinical series was performed. OBJECTIVE: To assess the effectiveness of orthotic treatment in male patients with idiopathic scoliosis and to compare with published data on female patients. SUMMARY OF BACKGROUND DATA: Although males have been included in bracing studies, the number of males has been small, and there have been no studies of exclusively male braced patients. METHODS: The medical records of 112 males with idiopathic scoliosis age > or =10 years who were prescribed orthoses were reviewed to confirm idiopathic etiology, determine the brace prescribed, and estimate compliance. Cobb angles and Risser signs were measured from radiographs at presentation, brace prescription, brace discontinuation, and final follow-up. Progression was defined as an increase in curve magnitude of 6 degrees. Surgical progression was defined as progression to 50 degrees and/or arthrodesis. The average age at brace prescription was 13.9 years, and 66% were Risser 0. Duration of treatment averaged 3.1 years. Curve magnitude at brace prescription averaged 33.1 degrees. The patients were observed an average of 1.2 years after the brace was discontinued. RESULTS: Progression of 6 degrees occurred in 74% of boys, and 46% reached surgical thresholds. Curve progression was related to immature Risser status but not to age or curve magnitude. Progression to surgery was related to immature Risser status and initial curve magnitude. Curves measuring > or =30 degrees progressed to surgical magnitudes in >50% of patients. Compliance was good in only 38% of patients. CONCLUSIONS: Bracing of male patients with idiopathic scoliosis is ineffective. Curves measuring > or =30 degrees are very likely to progress to surgery, especially in immature patients.
Authors: Kenneth M C Cheung; Elaine Y L Cheng; Samantha C W Chan; Kelvin W K Yeung; Keith D K Luk Journal: Int Orthop Date: 2006-08-01 Impact factor: 3.075