Abstract
Purpose
To evaluate outcome in patients with late onset juvenile scoliosis or adolescent idiopathic scoliosis 15 years or more after Boston brace treatment.
Methods
281 of 369 patients (22 men) with late onset juvenile (n=67) or adolescent (n=214) braced at mean 24.7 (range 16-32) years previously, responded to follow-up. Patients answered a standardized questionnaire including demographics, work status, Oswestry Disability Index (ODI) (100 - worst possible), EuroQol (EQ-5D) (1 – best possible), and Scoliosis Research Society - 22 (SRS - 22) (5 - best possible), and had radiological examination.
Results
The mean age at follow-up was 40.4 (31-48) years. The prebrace major curve was in average 33.2 (20–57)°. At weaning and at the last follow-up the corresponding values were 28.3 (1 -58)° and 32.5 (7–80)°, respectively. Curve progression was similar in patients with early onset juvenile and adolescent start. Those who did not attend follow-up (n=88) had lower mean curve at weaning: 25.4 (6-53)°. Twenty-six patients had surgery. Sixty-eight percent had an increase < 6° from prebrace major curve. Work status was: full time 75%, part-time 10%, sick-leave 2%, disability pension 9%, student 4%. 87% had delivered a baby, 51% had pain in pregnancy. The mean (SD) ODI was 8.4 (11.0), EQ-5D 0.82 (0.2), SRS-22: pain 4.1 (0.8), mental health 4.1 (0.6), self-image 3.7 (0.7), function 4.0 (0.6), satisfaction with treatment 3.7 (1.0). Patients who had surgery reported significantly worse scores except for satisfaction.
Conclusion
Long-term results were satisfactory in most braced patients.
Ethics approval: The committee for medical research ethics in the Health Region South-East in Norway and the hospital patient ombudsman approved the study.
Funding: The study was supported by grant from the Fondation Sophies Minde.
