Impact of the type of brace on the quality of life of Adolescents with Spine Deformities

Abstract

Study design: A group of 102 brace-treated adolescents, aged 10-19 years with spine deformities participated in a cross-sectional study.

Objectives: To determine the effect of various types of orthoses on self-perceived health status.

Summary of background data: Spinal orthosis is an effective means of controlling progressive scoliosis, but bracing has shown a considerable impact on several aspects of adolescent functioning.

Methods: Skeletally immature patients with spine deformities (75% with idiopathic scoliosis) who visited consecutively for routine biannual follow-up evaluations of orthotic treatment were studied. Twenty-five patients used the Milwaukee brace, 30 the Boston brace, 13 the thoracolumbosacral orthosis (TLSO), and 34 the Charleston bending orthosis. Patients completed the Quality of Life Profile for Spine Deformities (QLPSD), a specific instrument that measures quality of life in five areas labeled psychosocial functioning, sleep disturbances, back pain, body image, and back flexibility. Higher QLPSD scores mean a high level of impairment of quality of life.

Results: Milwaukee brace-treated patients scored significantly higher than Boston brace-treated and TLSO-braced patients and patients with Charleston bending orthosis in the overall QLPSD score (mean +/- SD, 53.60 +/- 13.26 vs. 45.65 +/- 12.81 and 42.79 +/- 12.99, respectively) and in back flexibility and psychosocial functioning. Other quality-of-life-related variables selected in multivariate analysis were the Risser sign, clinical diagnosis, duration of brace treatment, and degrees of correction.

Conclusion: In cases of different orthoses of proven similar effectiveness in controlling the scoliotic curves, the use of bracing with the lowest impact on the quality of life should be recommended.