TY - JOUR
T1 - The natural history of curve behavior after brace removal in adolescent idiopathic scoliosis
T2 - a literature review
AU - Luhmann, Scott
AU - Zaaroor-Regev, Daphna
AU - Upasani, Vidyadhar V.
AU - Shufflebarger, Harry
N1 - Funding Information:
Scott J. Luhmann receives Royalties from Medtronic, Stryker, Wolters, Globus and Orthopediatrics and is a Paid Consultant of Orthopediatrics. Daphna Zaaroor Regev is an employee of ApiFix Ltd. Vidyadhar V Upasani is an employee of Daedalus Medical solutions inc. A paid consultant of DePuy, A Johnson & Johnson company and Stryker. Receives research support from EOS imaging, nView, and Zimmer. Has stock and stock options at Imagen. Is an unpaid consultant of Indius and Pacira. Has royalties and is a paid consultant in Orthofix Inc., has royalties is a paid consultant and receives research support from Orthopediatrics. Is a board or committee member of POSNA and SRS. Is in the editorial or governing board of Spine and has publishing royalties, financial or material support from Wolters Kluwer Health. Harry Shufflebarger is a Consultant at Stryker Spine, Speaker's Bureau, has royalties. In OnPoint Surgical Medical Advisory Board.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/5
Y1 - 2023/5
N2 - Purpose: Brace treatment is the most common nonoperative treatment to prevent curve progression in adolescent idiopathic scoliosis (AIS). The goal of this review and analysis is to characterize curve behavior after completion of brace treatment and to identify factors that may facilitate the estimation of long-term curve progression. Method: A review of the English language literature was completed using the MEDLINE (PUBMED) database of publications after 1990 until September 2020. Studies were included if they detailed a minimum of 1 year post-brace removal follow-up of AIS patients. Data retrieved from the articles included Cobb angle measurements of the major curves at “in-brace,” weaning, and follow-up visit(s) for all patients described and for subset populations. Results: From 75 articles, 18 relevant studies describing a follow-up period of 1–25 years following brace removal were included in the analyses. The reviewed literature demonstrates that curves continue to progress after brace treatment is completed with three main phases of progression: (i) immediate (upon brace removal) where a mean curve progression of 7° occurs; (ii) short term (within five years of brace removal) where a relatively high progression rate is evident (0.8°/year); and (iii) long term (more than five years after brace removal) where the progression rate slows (0.2°/year). The magnitude and rate of curve progression is mainly dependent on the degree of curve at weaning as curves weaned at < 25° progress substantially less than curves weaned at ≥ 25° at 25 years. Conclusion: Curves continue to progress after brace removal and the rate and magnitude of progression are associated with the curve size at weaning, with larger curves typically exhibiting more rapid and severe progression. This analysis provides physicians and patients the ability to estimate long-term curve size based on the curve size at the time of weaning. Level of evidence: IV.
AB - Purpose: Brace treatment is the most common nonoperative treatment to prevent curve progression in adolescent idiopathic scoliosis (AIS). The goal of this review and analysis is to characterize curve behavior after completion of brace treatment and to identify factors that may facilitate the estimation of long-term curve progression. Method: A review of the English language literature was completed using the MEDLINE (PUBMED) database of publications after 1990 until September 2020. Studies were included if they detailed a minimum of 1 year post-brace removal follow-up of AIS patients. Data retrieved from the articles included Cobb angle measurements of the major curves at “in-brace,” weaning, and follow-up visit(s) for all patients described and for subset populations. Results: From 75 articles, 18 relevant studies describing a follow-up period of 1–25 years following brace removal were included in the analyses. The reviewed literature demonstrates that curves continue to progress after brace treatment is completed with three main phases of progression: (i) immediate (upon brace removal) where a mean curve progression of 7° occurs; (ii) short term (within five years of brace removal) where a relatively high progression rate is evident (0.8°/year); and (iii) long term (more than five years after brace removal) where the progression rate slows (0.2°/year). The magnitude and rate of curve progression is mainly dependent on the degree of curve at weaning as curves weaned at < 25° progress substantially less than curves weaned at ≥ 25° at 25 years. Conclusion: Curves continue to progress after brace removal and the rate and magnitude of progression are associated with the curve size at weaning, with larger curves typically exhibiting more rapid and severe progression. This analysis provides physicians and patients the ability to estimate long-term curve size based on the curve size at the time of weaning. Level of evidence: IV.
KW - Adolescent idiopathic scoliosis
KW - Brace treatment
KW - Curve progression
UR - http://www.scopus.com/inward/record.url?scp=85147101513&partnerID=8YFLogxK
U2 - 10.1007/s43390-022-00638-x
DO - 10.1007/s43390-022-00638-x
M3 - Review article
C2 - 36715866
AN - SCOPUS:85147101513
SN - 2212-134X
VL - 11
SP - 567
EP - 578
JO - Spine Deformity
JF - Spine Deformity
IS - 3
ER -