[Compliance as a prognostic factor in the treatment of idiopathic scoliosis]

Abstract

Background: The purpose of this study was to assess the compliance of brace treatment and the correlation with outcomes in patients with idiopathic scoliosis.

Methods: Ninety adolescent patients completed treatment with the Dresden scoliosis orthosis. After a mean follow-up time of 4.3 years, their level of compliance was retrospectively assessed and correlated with the radiographic results.

Results: The amount of primary correction was 36% in the lumbar spine and 25% in the thoracic spine. Of the patients, 59.4% were compliant (daily duration of brace treatment >20 h). The success rate in this group (improved or constant Cobb angles during therapy) was 89%. With good compliance and primary correction of more than 30%, the average Cobb angle at follow-up had improved by 8.3 degrees in the thoracic spine and by 12.4 degrees in the lumbar spine compared with the initial Cobb angle. Eleven of 39 patients in the noncompliant group but only four of 57 compliant patients underwent surgery.

Conclusion: Compliance with orthosis therapy and the amount of primary correction are together the most important factors for predicting the final outcome of brace treatment in idiopathic scoliosis. Influencing factors on compliance must be further analyzed.