JUVENILE IDIOPATHIC SCOLIOSIS: THE EFFECTIVENESS OF PART-TIME BRACING

Abstract

In order to determine the effectiveness of part-time bracing in juvenile idiopathic scoliosis (JIS) a retrospective review of thirty-four patients treated with a Charleston bending brace for JIS was undertaken. The patients were analyzed in three groups including:

1. success;

2. progression;

3. progression requiring surgery.

Of twenty-three patients meeting the inclusion criteria, nine achieved success, seven progressed, and seven required surgery. Success correlated with best in brace correction radiograph but not with initial curve magnitude. Part-time bracing is as successful as full-time bracing in JIS and better than the natural history.

In order to determine the effectiveness of part-time bracing in JIS, a retrospective review of thirty-four patients treated with a Charleston bending brace for JIS was undertaken.

Twenty-three patients met the inclusion criteria which included: curves greater than twenty degrees at initiation of bracing, Risser zero, bracewear more than twelve months, completion of the bracing program and Risser greater than or equal to four at final follow-up. Patients were analyzed in three groups, including

1. success (progression less than five degrees or less);

2. progression more than five degrees (but not requiring surgery) and

3. progression requiring surgery.

There were seven boys and sixteen girls with thirty-seven curves analyzed. Age at referral averaged 8.3 years. Average curve at time of bracing was thiry degrees. Length of bracing averaged 4.2 years with follow-up averaging 6.2 years. Nine patients met the criteria for success with seven patients progressing and seven patients requiring surgery. Of all curves, nineteen (51%) were successfully managed in the brace. Magnitude of curvature at initiation of bracing was not related to ultimate success, whereas success did correlate with higher best in brace correction radiographs.

Part-time bracing offers potential psychosocial and compliance benefits considering the length of treatment necessary in patients with juvenile idiopathic scoliosis. Although previous bracing studies have included some JIS patients, no authors have dealt specifically with the part-time bracing for JIS.

Part-time bracing is as successful as full-time bracing in JIS and better than the natural history.