4.5 Article

Rib-vertebral angle measurements predict brace treatment outcome in Risser grade 0 and premenarchal girls with adolescent idiopathic scoliosis

Journal

EUROPEAN SPINE JOURNAL
Volume 25, Issue 10, Pages 3088-3094

Publisher

SPRINGER
DOI: 10.1007/s00586-015-4372-5

Keywords

Adolescent idiopathic scoliosis; Rib-vertebral angle difference; Convex rib-vertebral angle; Brace treatment; Curve progression

Funding

  1. Development Project of Nanjing Science and Technology Commission and Foundation [201402028]
  2. Key Project of Medical Science and Technology Development Foundation, Nanjing Department of Health [YKK14053]
  3. National Natural Science Foundation of China [81301603]

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To investigate the predictive role of rib-vertebral angle (RVA) measurements in early adolescent idiopathic scoliosis (AIS) girls with right thoracic curve during brace treatment. Early AIS (premenarchal and Risser 0) girls who had undergone brace treatment and had been followed regularly were recruited to this study. According to the bracing outcome, they were divided into Group A (non-progressed) and Group B (curve worsened over six degrees or indicated for surgery). Totally 48 girls were included. There were 30 and 18 patients in Groups A and B, respectively. Ratio of curve progression was significantly higher in patients with initial RVA difference (RVAD) aeyen20A degrees versus < 20A degrees, or convex RVA (CRVA) aecurrency sign68A degrees versus > 68A degrees. From brace initiation to the latest follow-up, CRVA was found to be significantly higher in Group A versus Group B (P < 0.05), while RVAD was higher in Group B versus Group A (P < 0.05). Serial measurements revealed an increasing trend for RVAD (from 19 +/- 10A degrees to 29 +/- 8A degrees) yet a decreasing trend for CRVA (from 68 +/- 6A degrees to 60 +/- 7A degrees) in Group B, but both RVAD and CRVA were found to remain stable in Group A during the follow-up period. Association analyses showed that both RVAD aeyen20A degrees and CRVA aecurrency sign68A degrees at brace initiation and at each follow-up were significantly associated with curve progression. The initial RVAD aeyen20A degrees and CRVA aecurrency sign68A degrees serve as valid factors in predicting the risk of curve progression during bracing in early AIS. Constant watch on RVAD and CRVA can help to more accurately predict the effectiveness of bracing in these patients.

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