title: Curve Progression in Adolescent Idiopathic Scoliosis With a Minimum of 2 Years' Follow-up After Completed Brace Weaning With Reference to the SRS Standardized Criteria.
abstract: A retrospective study.
  
  
  
  To investigate curve evolution after brace weaning in adolescent idiopathic scoliosis (AIS) with reference to the Scoliosis Research Society (SRS) criteria.
  
  
  
  Previous studies mainly focused on curve evolution during bracing in AIS. However, curve progression after brace weaning was not well addressed.
  
  
  
  Braced AIS girls followed up for at least 2 years after brace weaning were reviewed. All patients had radiographs at initial visit, brace weaning, 6 months, 1 year, and 2 years after brace weaning, and last follow-up. Curve progression after brace weaning was separately defined as increase in Cobb angle >5 degrees and curve magnitude >45 degrees. The predictors for curve progression were identified using the independent t test.
  
  
  
  200 AIS girls were reviewed. The average duration of follow-up after brace weaning was 51.4 ± 25.6 months. Compared with brace weaning, at 6 months, 1 year, 2 years and last follow-up after brace weaning, 50 (25.0%), 60 (30.0%), 93 (46.5%), and 87 (43.5%) patients, respectively, had curve progression >5 degrees; 0 (0%), 0 (0%), 2 (1%), and 2 (1%) patients, respectively, had surgery recommended; among those with Cobb angle ≤40 degrees at brace weaning, 7 (4.0%), 11 (6.3%), 16 (9.2%), and 18 (10.3%) patients, respectively, had Cobb angle >45 degrees; the mean progression magnitudes were 2.6 ± 5.8, 3.5 ± 5.8, 5.1 ± 6.5, and 5.4 ± 7.4 degrees, respectively; and the mean progression rates were 0.34 ± 0.83, 0.16 ± 0.56, 0.13 ± 0.39, and 0.006 ± 0.28 degrees/month, respectively. Cobb angle at brace weaning was associated with increase in Cobb angle >5 degrees (p = .033) and curve magnitude >45 degrees (p < .001) after brace weaning.
  
  
  
  Curve progression after brace weaning is observed in 43.5% AIS patients. The highest risk occurs within 6 months after brace weaning whereas Cobb angle remains stable after 2 years' follow-up. High Cobb angle at brace weaning indicates high risk of curve progression after brace weaning.
  
  
  
  Level III.
authors.affiliation: Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Benlong
authors.initials: B
authors.lastname: Shi
authors.affiliation: Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
authors.affiliation: Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Saihu
authors.initials: S
authors.lastname: Mao
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Fiona W P
authors.initials: FW
authors.lastname: Yu
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Kwong Man
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Bobby K W
authors.initials: BK
authors.lastname: Ng
authors.affiliation: Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Zezhang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China.
authors.forename: Jack C Y
authors.initials: JC
authors.lastname: Cheng
authors.affiliation: Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong & Nanjing University, Nanjing, China. Electronic address: tplam@ort.cuhk.edu.hk.
authors.forename: Tsz Ping
authors.initials: TP
authors.lastname: Lam
mesh_terms: D000293:Adolescent; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies; D012600:Scoliosis / Q000628:therapy*; D016896:Treatment Outcome
keywords: Adolescent idiopathic scoliosis; Brace weaning; Curve progression; SRS