Abstract
Department of Epidemiology, ASL RM/E, Rome, Italy
School of Health and Social Care, University of Teesside, Middlesbrough, UK
Faculty of Health, Staffordshire University, Stoke on Trent, UK
Orthopaedic and Trauma Department, “Tzanio” General Hospital of Piraeus, Greece
University of Medical Sciences, Poznan, Poland
Department of Orthopaedic Surgery, Saitama Medical University, Kawagoe, Japan
Thriasio General Hospital, Athens, Greece
To evaluate the efficacy of bracing in adolescent patients with AIS.
Cochrane systematic review
The following databases were searched with no language limitations: the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINHAL and reference lists of articles. Extensive hand searching of grey literature was also conducted. RCT's and prospective cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces were included. Two review authors independently assessed trial quality and extracted data.
Two studies were included. There was very low quality evidence from one prospective cohort study including 286 girls1indicating that braces curbed curve progression, at the end of growth, (success rate 74%), better than observation, (34%) and electrical stimulation (33%). Another low quality evidence from one RCT with 43 girls indicated that a rigid brace is more successful than an elastic one (SpineCor) at limiting curve progression when measured in Cobb degrees2. No significant differences between the two groups in the subjective perception of daily difficulties associated with brace wearing were found.
There is very low quality evidence in favour of using braces, making generalization very difficult. The results from future studies may differ from these results. In the meantime, patients' choices should be informed by multidisciplinary discussion. Future research should focus on short and long-term patient-centred outcomes as well as measures such as Cobb angles. RCTs and prospective cohort studies should follow both the SRS and the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) criteria for bracing studies.
