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THE INFLUENCE OF COMPLIANCE AND INITIAL CORRECTION TO BRACE TREATMENT IN AIS



Abstract

Objective: The aim of the study is to get information about compliance as input of the patient and brace-correction as input of the technician for a successful treatment of Adolescent idiopathic scoliosis (AIS) with TLSO.

Study design: 234 patients with an idiopathic scoliosis (Cobb angle 20°–50°) were evaluated. Measurements were taken on standing radiographs (ap) before therapy, six months later and at least one year after weaning of the brace. Compliance was judged with compliance score into two groups with good and bad compliance. Also two groups with good (> 40% correction) and bad initial correction were formed.

Results: In patient with good compliance (n-188) and also good initial correction (n-136), a continuous correction of about 7°±4° Cobb angle was evident. Patient with good compliance but bad initial correction (n-45) can only expect a stop of progression. Patient with bad compliance (n-47) but good initial correction have shown progression of curvature with high variation (32°±6° to 37°±9°). Initial correction is low in cases with Cobb angle > 40° or > Risser II (n-21).

Conclusion: The result depends on the Cobb angle at the begin of therapy, brace correction and compliance. Initial correction gets worse in severe cases and cannot be compensated by compliance (Fulltime bracing).

The criteria of bracing have to be questioned: “In some cases we are to late”. In our recommendation we have to start earlier and a parttime-bracing has to be discussed in cases with Cobb angle < 30°

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org