A comparison of thoracolumbosacral orthoses and SpineCor treatment of adolescent idiopathic scoliosis patients using the Scoliosis Research Society standardized criteria.
BACKGROUND
SpineCor is a relatively new bracing system that uses dynamic bracing concepts in the treatment of adolescent idiopathic scoliosis (AIS). Limited data are available regarding its effectiveness. This study compared treatment outcomes of 2 groups of AIS patients treated via either a conventional rigid thoracolumbosacral orthoses (TLSO) or a SpineCor nonrigid orthosis.


METHODS
We identified 2 scoliosis patient cohorts: 35 patients treated with a TLSO and 32 patients treated with a SpineCor orthosis. All patients included in these groups conformed with the Scoliosis Research Society (SRS) standardized criteria for AIS bracing: (1) Risser < or =2, (2) curve magnitude 25 to 40 degrees, (3) age > or =10 years. Outcomes were SRS standardized with failure being defined as curve progression > or =6 degrees, or ever exceeding 45 degrees, or having surgery recommended before skeletal maturity. All patients were followed through the completion of brace treatment or attainment of other treatment end points. The Yates corrected chi test and unpaired t test were used for data analysis.


RESULTS
The 35 patients (32 girls, 3 boys) in the TLSO group had an average age of 13 years (range: 11.1-16.8) and an average primary curve magnitude of 33 degrees (range: 25-40 degrees). Follow-up averaged 2 years (range: 8-61 m) from the beginning of brace treatment. The 32 patients (28 girls, 4 boys) in the SpineCor group had an average age of 13 years (range: 11-15.2) and an average primary curve magnitude of 31 degrees (range: 25-40 degrees). Follow-up for this group averaged 2 years and 6 months (range: 13-73 mo) from the beginning of brace treatment. No significant difference (P=0.75) was found using the more strict outcome measure (< or =5-degree curve progression) as the success rates were 60% (21/35) for TLSO and 53% (17/32) for SpineCor. Similarly, no significant difference (P=0.62) was found using the more liberal outcome measure (never reached 45 degrees) as the success rates were 80% (28/35) for TLSO and 72% (23/32) for SpineCor.


CONCLUSIONS
We were unable to identify any significant differences in brace treatment outcomes when comparing TLSO and SpineCor treated patients.
Gammon
Steven R
SR
Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH 45229-3039, USA.
Mehlman
Charles T
CT
Chan
Winston
W
Heifetz
Jonathan
J
Durrett
Gregory
G
Wall
Eric J
EJ
D000293:Adolescent; D001915:Braces; D002648:Child; D015331:Cohort Studies; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D012447:Sacrum; D012600:Scoliosis / Q000473:pathology / Q000628:therapy*; D012955:Societies, Medical; D013904:Thoracic Vertebrae; D016896:Treatment Outcome