title: Effect of preoperative brace treatment on quality of life in adolescents with idiopathic scoliosis following corrective surgery.
abstract: Bracing is frequently used for the treatment of adolescent idiopathic scoliosis. Such treatment is not always effective, and corrective surgery may be warranted. Brace treatment has been suggested to negatively affect quality of life. This study assessed postoperative quality of life and surgical outcome in Chinese patients with adolescent idiopathic scoliosis and failed brace treatment. Ninety-four patients with adolescent idiopathic scoliosis who underwent simple posterior corrective surgery and pedicle screw fixation were studied. The patients were divided into 2 groups: brace and surgery treatment (BS group) and surgery with no brace treatment (S group). Radiological parameters were assessed preoperatively, immediately postoperatively, and >2 years postoperatively. Postoperative quality of life was determined using the Scoliosis Research Society-22 (SRS-22) questionnaire. The preoperative minor curve Cobb angle was significantly greater in the BS group (34.9 degrees vs 29.4 degrees ; P=.037). Postoperative radiological parameters in the coronal and sagittal planes were similar. There were a significantly higher number of fused vertebrae in BS compared to S group patients (10.3 vs 9.6; P=.044). There were no significant postoperative differences between groups in function/activity, pain, mental health, or satisfaction of management as determined by the SRS-22. Self-image/appearance scores were significantly higher in BS compared to S group patients (4.0 vs 3.8; P=.010). Preoperative brace treatment may be a risk factor for minor curve progression but does not appear to significantly influence surgical outcome. Postoperative self-perceived quality of life is not negatively affected by preoperative brace treatment.
authors.affiliation: Department of Spine Surgery, Changhai Hospital, Second Military Medical University, National Key Department of Spine Surgery, 174 Changhai Rd., Shanghai, People's Republic of China.
authors.forename: Chuanfeng
authors.initials: C
authors.lastname: Wang
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Zhao
authors.forename: Shisheng
authors.initials: S
authors.lastname: He
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
authors.forename: Yingchuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Chen
authors.forename: Suxi
authors.initials: S
authors.lastname: Gu
authors.forename: Yang
authors.initials: Y
authors.lastname: Xie
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D001915:Braces; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012600:Scoliosis / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome