Fabio Zaina1, Sabrina Donzelli2, Stefano Negrini3,4. 1. ISICO (Italian Scientific Spine Institute), Via Roberto Bellarmino 13/1, 20141, Milan, MI, Italy. fabio.zaina@isico.it. 2. ISICO (Italian Scientific Spine Institute), Via Roberto Bellarmino 13/1, 20141, Milan, MI, Italy. 3. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 4. IRCCS Don Gnocchi Foundation, Milan, Italy.
Abstract
PURPOSE: Overweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AIS patients. METHODS: Design: retrospective cohort study. POPULATION: 351 AIS patients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2. INCLUSION CRITERIA: no previous treatment, full-time prescription of brace at first visit (18-23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated. OUTCOME: improved, progressed, and stable according to the 5° Cobb agreed threshold. STATISTICS: a stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied. RESULTS: BMI is poorly correlated with final results. Confounders' adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively. DISCUSSION: Brace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.
PURPOSE: Overweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AISpatients. METHODS: Design: retrospective cohort study. POPULATION: 351 AISpatients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2. INCLUSION CRITERIA: no previous treatment, full-time prescription of brace at first visit (18-23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated. OUTCOME: improved, progressed, and stable according to the 5° Cobb agreed threshold. STATISTICS: a stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied. RESULTS: BMI is poorly correlated with final results. Confounders' adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively. DISCUSSION: Brace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.
Authors: Manon van den Bogaart; Barend J van Royen; Tsjitske M Haanstra; Marinus de Kleuver; Sayf S A Faraj Journal: Eur Spine J Date: 2019-01-03 Impact factor: 3.134