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A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis - A follow-up mean of 16 years after maturity

Danielsson, Aina J.; Hasserius, Ralph LU ; Ohlin, Acke LU and Nachemson, Alf L. (2007) In Spine 32(20). p.2198-2207
Abstract
Study Design. The Swedish patients included in the previous SRS brace study were invited to take part in a long-term follow-up. Objective. To investigate the rate of scoliosis surgery and progression of curves from baseline as well as after maturity. Summary of Background Data. Brace treatment was shown to be superior to electrical muscle stimulation, as well as observation alone, in the original SRS brace study. Few other studies have shown that brace treatment is effective in the treatment of scoliosis. Methods. Of 106 patients, 41 in Malmo ( all Boston brace treatment) and 65 in Goteborg ( observation alone as the intention to treat), 87% attended the follow-up, including radiography and chart review. All radiographs were ( re) measured... (More)
Study Design. The Swedish patients included in the previous SRS brace study were invited to take part in a long-term follow-up. Objective. To investigate the rate of scoliosis surgery and progression of curves from baseline as well as after maturity. Summary of Background Data. Brace treatment was shown to be superior to electrical muscle stimulation, as well as observation alone, in the original SRS brace study. Few other studies have shown that brace treatment is effective in the treatment of scoliosis. Methods. Of 106 patients, 41 in Malmo ( all Boston brace treatment) and 65 in Goteborg ( observation alone as the intention to treat), 87% attended the follow-up, including radiography and chart review. All radiographs were ( re) measured for curve size ( Cobb method) by an unbiased examiner. Searching in the mandatory national database for performed surgery identified patients who had undergone surgery after maturity. Results. The mean follow-up time was 16 years and the mean age at follow- up was 32 years The 2 treatment groups had equal curve size at inclusion. The curve size of patients who were treated with a brace from the start was reduced by 6 during treatment, but the curve size returned to the same level during the follow- up period. No patients who were primarily braced went on to undergo surgery. In patients with observation alone as the intention to treat, 20% were braced during adolescence due to progression and another 10% underwent surgery. Seventy percent were only observed and increased by 6 from inclusion until now. No patients underwent surgery after maturity. Progression was related to premenarchal status. Conclusion. The curves of patients with adolescent idiopathic scoliosis with a moderate or smaller size at maturity did not deteriorate beyond their original curve size at the 16-year follow- up. No patients treated primarily with a brace went on to undergo surgery, whereas 6 patients (10%) in the observation group required surgery during adolescence compared with none after maturity. Curve progression was related to immaturity. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
outcome, curve size, observation, brace treatment, scoliosis, adolescents
in
Spine
volume
32
issue
20
pages
2198 - 2207
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000249580300008
  • scopus:34548702002
ISSN
0362-2436
language
English
LU publication?
yes
id
be4e533f-b1d6-4909-a485-d5f086b3da18 (old id 656359)
date added to LUP
2007-12-11 11:16:51
date last changed
2017-10-22 04:39:08
@article{be4e533f-b1d6-4909-a485-d5f086b3da18,
  abstract     = {Study Design. The Swedish patients included in the previous SRS brace study were invited to take part in a long-term follow-up. Objective. To investigate the rate of scoliosis surgery and progression of curves from baseline as well as after maturity. Summary of Background Data. Brace treatment was shown to be superior to electrical muscle stimulation, as well as observation alone, in the original SRS brace study. Few other studies have shown that brace treatment is effective in the treatment of scoliosis. Methods. Of 106 patients, 41 in Malmo ( all Boston brace treatment) and 65 in Goteborg ( observation alone as the intention to treat), 87% attended the follow-up, including radiography and chart review. All radiographs were ( re) measured for curve size ( Cobb method) by an unbiased examiner. Searching in the mandatory national database for performed surgery identified patients who had undergone surgery after maturity. Results. The mean follow-up time was 16 years and the mean age at follow- up was 32 years The 2 treatment groups had equal curve size at inclusion. The curve size of patients who were treated with a brace from the start was reduced by 6 during treatment, but the curve size returned to the same level during the follow- up period. No patients who were primarily braced went on to undergo surgery. In patients with observation alone as the intention to treat, 20% were braced during adolescence due to progression and another 10% underwent surgery. Seventy percent were only observed and increased by 6 from inclusion until now. No patients underwent surgery after maturity. Progression was related to premenarchal status. Conclusion. The curves of patients with adolescent idiopathic scoliosis with a moderate or smaller size at maturity did not deteriorate beyond their original curve size at the 16-year follow- up. No patients treated primarily with a brace went on to undergo surgery, whereas 6 patients (10%) in the observation group required surgery during adolescence compared with none after maturity. Curve progression was related to immaturity.},
  author       = {Danielsson, Aina J. and Hasserius, Ralph and Ohlin, Acke and Nachemson, Alf L.},
  issn         = {0362-2436},
  keyword      = {outcome,curve size,observation,brace treatment,scoliosis,adolescents},
  language     = {eng},
  number       = {20},
  pages        = {2198--2207},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Spine},
  title        = {A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis - A follow-up mean of 16 years after maturity},
  volume       = {32},
  year         = {2007},
}