The efficacy of bracing in the treatment of progressive early-onset scoliosis

• Published in: Scientific reports 2024-05, Vol.14 (1), p.10208-10208, Article 10208
• Main Authors: Li, Haixia, Wu, Jigong, Song, Lizhi, Shao, Shuilin, Chen, Zhiming, Wang, Jiaxu, Gao, Bo, Huo, Litao
• Format: Article
• Language: English
• Subjects: 692/308/3187; 692/308/409; Age; Age of Onset; Braces; Bracing; Child; Child, Preschool; Delaying surgery; Disease Progression; Female; Follow-Up Studies; Humanities and Social Sciences; Humans; Male; multidisciplinary; Nonsurgical; Patients; Progressive early-onset scoliosis; Retrospective Studies; Rib-vertebral angle difference; Science; Science (multidisciplinary); Scoliosis; Scoliosis - therapy; Thorax; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-61030-5

Serial casting as one of the applications to treat early-onset scoliosis has been reported efficiently to improve deformity, but no report has focused on the efficacy of braces in the treatment of congenital early-onset scoliosis and comparison with progressive idiopathic early-onset scoliosis. Patients with progressive EOS treated with braces in our institution with a minimum of 4 years follow-up were reviewed. Two groups according to the etiological diagnosis were analyzed and compared: the congenital scoliosis (CS) group and idiopathic scoliosis (IS) group. The success cases and the failure cases were also compared. 27 patients with an average main Cobb angle of 38.19° (20–55) underwent initial bracing at an average age of 55.7 months (24–108), the average follow-up time was 76.19 months (49–117). In IS group the main Cobb angle was corrected to 18.69 ± 12.06° (48.61%) following the first bracing; the final Cobb angle was 23.08 ± 22.15°(38.76%) after brace removal. In CS group the main Cobb angle was corrected to 33.93 ± 10.31°(17.1%) following the first bracing and 37.93 ± 14.74°(3.53%) after brace removal. Both coronal chest width and T1-T12 height increased dramatically from pre-bracing to the last follow-up. Patients diagnosed as IS tended to have a better result in main Cobb angle correction than that of CS ( P  = 0.049). By the time of last follow-up, 8 patients had undergone surgery, and the operation time was postponed by 68.88 ± 26.43 months. For patients with progressive early-onset scoliosis, bracing is an efficient nonsurgical alternative to casting, and some of them can be cured; if not, eventual surgical intervention can be delayed for a period of time without restrictions on the thoracic cavity.