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How to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria.

Zaina F, Negrini S, Fusco C, Atanasio S - Scoliosis (2009)

Bottom Line: At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p < 0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline).Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria.This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical.

View Article: PubMed Central - HTML - PubMed

Affiliation: ISICO, Milan, Italy. fabio.zaina@isico.it

ABSTRACT

Background: Aesthetics is a main goal of both conservative and surgical treatments in adolescent idiopathic scoliosis (AIS). Previously, we developed and validated a clinical scale - the Aesthetic Index (AI)--in order to measure aesthetic impairment and changes during treatment.

Aim: To verify the efficacy of bracing on aesthetics in AIS.

Study design: Prospective Cohort Study.

Population: Thirty-four consecutive patients, age 13.2 +/- 3.7, initial Cobb Angle 32 +/- 12 degrees , ATR 10 +/- 4 degrees Bunnel, 11 males.

Methods: Patients with AI scores of at least 5/6 were included. Each of them had a brace prescription (18 to 23 hours per day), according to the SPoRT concept. AI was measured again after six months and at the end of treatment, and then the pre- and post-treatment scores compared. The Wilcoxon test was performed.

Results: Twenty-nine patients out of the 34 included completed the treatment and had six-month and final results; four patients were lost during the treatment, and one was fused. At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p < 0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline).

Conclusion: Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria. This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical. The use of a more sensitive tool like TRACE could more easily detect the clinical changes; nevertheless, AI proved sensible enough that its use in everyday clinical practice can be suggested.

No MeSH data available.


Related in: MedlinePlus

A frontal view of the Sforzesco brace.
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Figure 2: A frontal view of the Sforzesco brace.

Mentions: Twenty-nine patients out of the 34 included completed the treatment and had both six months and final results; four patients were lost during the treatment, and one was fused. The mean duration of the treatment was 2.5 years (SD 2.1). At baseline, the median AI was a score of 6 (95% IC 5-6), after six months of brace treatment the AI score decreased to 3 (95% IC 0-5; p < 0.05), and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline). At six months, all but one patient had improved by at least one point (Fig 1, 2, 3, 4). No differences were detected from 6 months evaluation and the final result.


How to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria.

Zaina F, Negrini S, Fusco C, Atanasio S - Scoliosis (2009)

A frontal view of the Sforzesco brace.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2743641&req=5

Figure 2: A frontal view of the Sforzesco brace.
Mentions: Twenty-nine patients out of the 34 included completed the treatment and had both six months and final results; four patients were lost during the treatment, and one was fused. The mean duration of the treatment was 2.5 years (SD 2.1). At baseline, the median AI was a score of 6 (95% IC 5-6), after six months of brace treatment the AI score decreased to 3 (95% IC 0-5; p < 0.05), and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline). At six months, all but one patient had improved by at least one point (Fig 1, 2, 3, 4). No differences were detected from 6 months evaluation and the final result.

Bottom Line: At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p < 0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline).Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria.This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical.

View Article: PubMed Central - HTML - PubMed

Affiliation: ISICO, Milan, Italy. fabio.zaina@isico.it

ABSTRACT

Background: Aesthetics is a main goal of both conservative and surgical treatments in adolescent idiopathic scoliosis (AIS). Previously, we developed and validated a clinical scale - the Aesthetic Index (AI)--in order to measure aesthetic impairment and changes during treatment.

Aim: To verify the efficacy of bracing on aesthetics in AIS.

Study design: Prospective Cohort Study.

Population: Thirty-four consecutive patients, age 13.2 +/- 3.7, initial Cobb Angle 32 +/- 12 degrees , ATR 10 +/- 4 degrees Bunnel, 11 males.

Methods: Patients with AI scores of at least 5/6 were included. Each of them had a brace prescription (18 to 23 hours per day), according to the SPoRT concept. AI was measured again after six months and at the end of treatment, and then the pre- and post-treatment scores compared. The Wilcoxon test was performed.

Results: Twenty-nine patients out of the 34 included completed the treatment and had six-month and final results; four patients were lost during the treatment, and one was fused. At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p < 0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline).

Conclusion: Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria. This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical. The use of a more sensitive tool like TRACE could more easily detect the clinical changes; nevertheless, AI proved sensible enough that its use in everyday clinical practice can be suggested.

No MeSH data available.


Related in: MedlinePlus