Predictive factors of Osaka Medical College (OMC) brace treatment in patients with adolescent idiopathic scoliosis
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RESEARCH
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Predictive factors of Osaka Medical College (OMC) brace treatment in patients with adolescent idiopathic scoliosis Hiroshi Kuroki1*, Naoki Inomata2, Hideaki Hamanaka2, Kiyoshi Higa2, Etsuo Chosa2 and Naoya Tajima3
Abstract Background: Factors influencing clinical course of brace treatment apply to adolescent idiopathic scoliosis (AIS) patients remain unclear. By making clear them, we may select suitable patients for brace treatment and alleviate overtreatment. The purpose of this study was to explore predictive factors of Osaka Medical College (OMC) brace treatment for AIS patients in accordance with the modified standardized criteria proposed by the Scoliosis Research Society (SRS) committee on bracing and non-operative management. Methods: From 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. We investigated the clinical course and evaluated the impacts of compliance, initial brace correction rate, curve flexibility, curve pattern, Cobb angle, chronological age, and Risser stage to clinical outcomes. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria. Results: The curve progressed in 10 cases, the curve improved in 6 cases, and the curve remained unchanged in 15 cases (success rate: 67.7%). The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% as compared with in those 50% or less. Initial brace correction rate, curve flexibility, curve pattern, the magnitude of Cobb angle, chronological age, and Risser stage did not have any significant effect for clinical courses. However, success rate was insignificantly higher in the cases whose Cobb angle in brace was smaller than that in hanging position. Conclusions: OMC brace treatment could alter the natural history of AIS, however, that was significantly affected by compliance of brace wear. Keywords: Adolescent idiopathic scoliosis (AIS), Osaka Medical College (OMC) brace, Conservative treatment, Predictive factor, Standardized inclusion and assessment criteria, Scoliosis Research Society (SRS)
Introduction Current treatment for adolescent idiopathic scoliosis (AIS) is divided into operative treatment and non-operative treatment. In the past, various non-operative treatments, including exercise, physical therapy, electrical stimulation, and brace treatment have been tried to delay or prevent the curve progression. Of those, brace treatment is the only widely accepted and demonstrated the efficacy to * Correspondence: [email protected] 1 Department of Orthopaedic Surgery, National Hospital Organization Miyazaki Higashi Hospital, 4374-1 Tayoshi Ooaza, Miyazaki 880-0911, Japan Full list of author information is available at the end of the article
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