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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 August;63(4):257-61
Orthotic treatment for adolescent idiopathic scoliosis: evaluation of efficacy based on clinical outcomes
Gennari E. 1, Trucchi F. 2, Maiello A. 2, Blonna D. 2, Pellegrino P. 1, Sito G. 1, Gastaldo C. 1, Albenga E. 1, Collo G. 3, Rosso V. 4, Castoldi F. 2
1 University of Turin;
2 Division of Orthopedics and Traumatology, Ospedale Mauriziano Umberto I, Turin, Italy;
3 Division of Orthopedics and Traumatology, Ospedale CTO-Maria Adelaide, Turin, Italy;
4 Unit of Orthopedics, Alba-Bra Hospital, Alba, Cuneo, Italy
Aim. The purpose of our study was to evaluate the effectiveness of the orthotic treatment in the evolution of adolescent idiopathic scoliosis and to compare our results with a predictor index of curve progression, developed by Lonstein.
Methods. In our retrospective study we included all the patients respecting the Scoliosis Research Society (SRS) criteria: age 10 years or older at initiation of brace; initial curve of 25° or 40°; Risser sign 0 to 2; no previous treatment; female: premenarcheal or less than 1 year past menarche. We evaluated these orthotic devices: Charleston Bending Brace, Cheneau brace, Michel brace and EDF-Lionese treatment. At the end of the treatment, we considered the curves, basing on radiological signs and SRS outcome criteria, like worsened, improved or unchanged.
The percentage of worsened curves has been compared with Lonstein’s prediction of curve progression. We used Lonstein factor 1.9 to define a patient with a high probability of progression (80% of prediction of curve progression in untreated idiopathic scoliosis).
Results. Seventeen percent of cases with Lonstein’s index 1.9 or more is worsened, versus 80% predicted by the Lonstein’s index (P<0.001).
Conclusion. Upon these results, we may confirm good efficacy of braces in treatment of adolescent idiopathic scoliosis.