Braces for idiopathic scoliosis in adolescents

Stefano Negrini, Silvia Minozzi, Josette Bettany-Saltikov, Fabio Zaina, Nachiappan Chockalingam, Theodoros B. Grivas, Tomasz Kotwicki, Toru Maruyama, Michele Romano, E. S. (Elias) Vasiliadis

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    Abstract

    Objective: To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on qualityof life, disability, pulmonary disorders, progression of the curve, psychological and cosmetic issues.Summary of Background DataIdiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed inadolescence. While adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surfacedeformity, it is usually not symptomatic.

    Methods: Search methods - We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February2015. We also checked reference lists and hand searched grey literature.Selection criteriaRCTs and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery,and different types of braces for adolescent with AIS.

    Data collection and analysis: We used standard methodological procedures expected by The Cochrane Collaboration.ResultsWe included seven studies. Five were planned as RCTs, two as prospective CCT`s. One RCT failed completely,another was continued as an observational study. There was very low quality evidence from one small RCT that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation.

    Conclusions: Two studies showed that bracing did not change QoL during treatment, and QoL, back pain psychological andcosmetic issues in the long term (16 years.) All papers showed that bracing prevented curve progression. Thehigh rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parentsreject randomization of their children.
    Original languageEnglish
    Pages (from-to)-
    JournalSpine
    DOIs
    Publication statusPublished - 31 Aug 2016

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