EFFECTIVENESS OF GENSINGEN BRACE TREATMENT FOR ADOLESCENT IDIOPATHIC SCOLIOSIS: A PROSPECTIVE COHORT STUDY


Akgül T., Karalar Ş., Bayram S., Altan M.

The Journal of Turkish Spinal Surgery, cilt.31, sa.3, ss.130-134, 2020 (Hakemli Dergi)

Özet

Objective: The efficacy of brace treatment for patients with adolescent idiopathic scoliosis (AIS) remains controversial. This study aimed to evaluate the effectiveness of Gensingen brace treatment in patients with AIS (identified using the Scoliosis Research Society inclusion criteria) and explore factors affecting treatment success rates.
Materials and Methods: This study included twenty-five patients diagnosed with AIS and treated using a Gensingen brace between April 2015 and February 2018. Initial brace correction rates and progression of the main curves were evaluated. Treatment outcomes were classified into a) progression if≥ 6 increase in curvature was observed and b) improvement in case of≥ 6 decrease in curvature. The association between treatment success rate and age, gender, Lenke classification, Risser grade, initial Cobb angle, and rotation grade was examined. Results: The spinal curvature was seen to progress in 13 cases, improve in two cases, and remain unchanged in 10 cases, yielding a success rate of 48%(12/25). Moreover, only three out of 25 cases exhibited progression of the Cobb angle above 45 requiring surgery. The mean pre-brace Cobb angle of the main curves was 27.9±6.7 (range: 20 to 37) and the mean duration of brace treatment was 37.2 months (range: 6-76 months). The mean Cobb angle at the end of treatment was 32.1±8.2 (range: 15 to 45). Successful treatment outcomes were correlated with initial Cobb angle (r= 0.680; p=< 0.001), rotation grade (r=-0.458; p= 0.028), and main thoracic Lenke classification (r= 0.481; p= 0.020), although no such association with age and Risser grade was observed …