This systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis. A comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included.Aims
Methods
To systematically evaluate whether bracing can effectively achieve curve regression in patients with adolescent idiopathic scoliosis (AIS), and to identify any predictors of curve regression after bracing. Two independent reviewers performed a comprehensive literature search in PubMed, Ovid, Web of Science, Scopus, and Cochrane Library to obtain all published information about the effectiveness of bracing in achieving curve regression in AIS patients. Search terms included “brace treatment” or “bracing,” “idiopathic scoliosis,” and “curve regression” or “curve reduction.” Inclusion criteria were studies recruiting patients with AIS undergoing brace treatment and one of the study outcomes must be curve regression or reduction, defined as > 5° reduction in coronal Cobb angle of a major curve upon bracing completion. Exclusion criteria were studies including non-AIS patients, studies not reporting p-value or confidence interval, animal studies, case reports, case series, and systematic reviews. The GRADE approach to assessing quality of evidence was used to evaluate each publication.Aims
Methods
The aim of this study was to assess the ability of morphological spinal parameters to predict the outcome of bracing in patients with adolescent idiopathic scoliosis (AIS) and to establish a novel supine correction index (SCI) for guiding bracing treatment. Patients with AIS to be treated by bracing were prospectively recruited between December 2016 and 2018, and were followed until brace removal. In all, 207 patients with a mean age at recruitment of 12.8 years (SD 1.2) were enrolled. Cobb angles, supine flexibility, and the rate of in-brace correction were measured and used to predict curve progression at the end of follow-up. The SCI was defined as the ratio between correction rate and flexibility. Receiver operating characteristic (ROC) curve analysis was carried out to assess the optimal thresholds for flexibility, correction rate, and SCI in predicting a higher risk of progression, defined by a change in Cobb angle of ≥ 5° or the need for surgery.Aims
Methods
The magnetically controlled growing rod (MCGR) system allows growth maintenance without the risk of anaesthesia, implant and wound complications associated with repeated surgeries. This is a medium-term report of the complications of MCGR from a multicentre study. Twenty-six patients from 6 spine institutes that are part of a multicentre study with prospectively collected data of minimum 24 months follow-up were assessed. Pre-operative, immediate post-operative and most recent spine radiographs were reviewed to measure the Cobb angle and the rod lengthening distance. The causes and any associated risk factors for re-operations were examined. Eleven patients required re-operation within the follow-up period, with a mean time to re-operation of 17 months after the initial surgery. Five were due to failure of rod distractions; 3 were due to failure of proximal foundation implants; 2 were due to rod breakage; and one case of superficial wound infection with failure of proximal fixation. Proximal junctional kyphosis occurred in 5 patients. Three had proximal anchor dislodgement and all five constructs were revised. This is the largest series with the longest follow-up to date. Our series show that the perception that using MCGR may reduce the frequency of re-operations may not be entirely true. This is the first report to examine the need for re-operation after MCGR implantation, and highlights the inherent risks of any surgical treatment in this group of patients despite the advantages of this new implant. Longer-term studies and comparisons with traditional growing rods are required.
