Clinical Outcomes of Bracing for Early Onset Idiopathic Scoliosis: A Retrospective Cohort Study on 111 Patients
Invited conference paper presented and published in conference proceedings
CUHK Authors
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AbstractIntroduction
Bracing is one of first-line treatment for Early Onset Idiopathic Scoliosis (EOIS) to control
curves from progression. Few studies examined the effects of bracing for EOIS. This study
aimed to explore the determinants that govern bracing effectiveness in EOIS.
Methods
One hundred and eleven EOIS patients below 10 year old, treated with bracing and with final
follow-up beyond skeletal maturity were identified from records between 1988-2021 for
intention-to-treat analysis. Demographic data (gender, age, maturity, and bracing duration) and
clinical features (curve type, Cobb angles and in-brace correction) were obtained. Correlation
analyses were used to determine the associations between curve outcomes and clinical features.
Results
Ninety-five of EOIS were female (85.6 %) and 16 were male (14.4%). When first diagnosed,
mean age was 8.6 years old (SD=1.25) with an average follow-up period of 9.41 years
(SD=4.04), almost all were Risser 0 (99.1%) and mostly had major curve at left side (67%).
The mean baseline Cobb angle of major curves was 21.73˚ (SD=7.92) with a mean Cobb angle
progression of 18.05˚ (SD=19.11). Average bracing duration was 5.3 years (SD=1.9). Only 6
(23.4%) of them underwent surgery. Female EOIS had an average 3.04 years (SD=1.98) before
menarche when first diagnosed and an average of 5.91 years (SD=4.05) post-menarche at last
follow-up. The final Cobb angle and curve progression at final follow-up with Cobb angle of
≥50° were positively correlated with initial Cobb angle (r=0.206 and r=0.313 respectively) and
negatively correlated with maturity parameters. Lumbar curve type was also found to correlate
with smaller final Cobb angle.
Conclusion
Most EOIS had a final Cobb angle less than 50˚ which was considered as a successful bracing
outcome. Final Cobb angle correlated with initial Cobb angle and curve types observed in EOIS.
Future multi-centre studies with longer follow-up after weaning are warranted.
Bracing is one of first-line treatment for Early Onset Idiopathic Scoliosis (EOIS) to control
curves from progression. Few studies examined the effects of bracing for EOIS. This study
aimed to explore the determinants that govern bracing effectiveness in EOIS.
Methods
One hundred and eleven EOIS patients below 10 year old, treated with bracing and with final
follow-up beyond skeletal maturity were identified from records between 1988-2021 for
intention-to-treat analysis. Demographic data (gender, age, maturity, and bracing duration) and
clinical features (curve type, Cobb angles and in-brace correction) were obtained. Correlation
analyses were used to determine the associations between curve outcomes and clinical features.
Results
Ninety-five of EOIS were female (85.6 %) and 16 were male (14.4%). When first diagnosed,
mean age was 8.6 years old (SD=1.25) with an average follow-up period of 9.41 years
(SD=4.04), almost all were Risser 0 (99.1%) and mostly had major curve at left side (67%).
The mean baseline Cobb angle of major curves was 21.73˚ (SD=7.92) with a mean Cobb angle
progression of 18.05˚ (SD=19.11). Average bracing duration was 5.3 years (SD=1.9). Only 6
(23.4%) of them underwent surgery. Female EOIS had an average 3.04 years (SD=1.98) before
menarche when first diagnosed and an average of 5.91 years (SD=4.05) post-menarche at last
follow-up. The final Cobb angle and curve progression at final follow-up with Cobb angle of
≥50° were positively correlated with initial Cobb angle (r=0.206 and r=0.313 respectively) and
negatively correlated with maturity parameters. Lumbar curve type was also found to correlate
with smaller final Cobb angle.
Conclusion
Most EOIS had a final Cobb angle less than 50˚ which was considered as a successful bracing
outcome. Final Cobb angle correlated with initial Cobb angle and curve types observed in EOIS.
Future multi-centre studies with longer follow-up after weaning are warranted.
All Author(s) ListRufina Wing- lum Lau, Alec Lik-hang Hung, Kee Ho-man, Leo Chung-hei Wong, Victor Kin-wai Chan, Derek Wai-yin Chung, Jerry Kwok-to Chan, Bosco Kin-pok Chau, Stanley Ho-fung Leung, Jack Chun-yiu Cheng, Tsz-Ping Lam
Name of ConferenceTW-HK Symposium 2022
Start Date of Conference26/06/2022
End Date of Conference26/06/2022
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Year2022
LanguagesEnglish-United States
