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Randomized Controlled Trial
. 2016 Dec 1;41(23):1813-1825.
doi: 10.1097/BRS.0000000000001887.

Braces for Idiopathic Scoliosis in Adolescents

Stefano Negrini  1 , Silvia Minozzi  2 , Josette Bettany-Saltikov  3 , Nachiappan Chockalingam  4 , Theodoros B Grivas  5 , Tomasz Kotwicki  6 , Toru Maruyama  7 , Michele Romano  8 , Fabio Zaina  8
Affiliations
Free article
Randomized Controlled Trial

Braces for Idiopathic Scoliosis in Adolescents

Stefano Negrini et al. Spine (Phila Pa 1976). .
Free article

Abstract

Study design: A Cochrane systematic review.

Objective: To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological, and cosmetic issues.

Summary of background data: Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. Although adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic.

Methods: We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015. We also checked reference lists and hand searched grey literature. Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. We used standard methodological procedures expected by the Cochrane Collaboration.

Results: We included seven studies. Five were planned as RCTs, two as prospective controlled clinical trials. One RCT failed completely, another was continued as an observational study. There was very low quality evidence from one small RCT that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation.

Conclusion: Two studies showed that bracing did not change QoL during treatment, and QoL, back pain psychological and cosmetic issues in the long term (16 years.) All articles showed that bracing prevented curve progression. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children.

Level of evidence: 1.

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References

    1. Negrini S, Aulisa AG, Aulisa L, Durmala J, et al. 2011 SOSORT guidelines: orthopedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012; 7:3.
    1. Hresko MT. Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med 2013; 368:834–841.
    1. Grivas TB, Vasiliadis E, Mouzakis V, et al. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes. Scoliosis 2006; 1:9.
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    1. Parent S, Newton PO, Wenger DR. Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing. Instr Course Lect 2005; 54:529–536.

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