Abstract
Purpose
While the Scoliosis Research Society (SRS) has established criteria for brace initiation in adolescent idiopathic scoliosis (AIS), there are no recommendations concerning other management issues. As the BrAIST study reinforced the utility of bracing, the SRS Non-Operative Management Committee decided to evaluate the consensus or discord in AIS brace management.
Methods
1200 SRS members were sent an online survey in 2017, which included 21 items concerning demographics, bracing indications, management, and monitoring. Free-text responses were analyzed and collated into common themes. Data were analyzed using Microsoft Excel 2013.
Results
Of 218 respondents; 207 regularly evaluate and manage patients with AIS, and 205 currently prescribe bracing. 99% of respondents use bracing for AIS and the majority (89%) use the published SRS criteria, or a modified version, to initiate bracing. 85% do not use brace monitoring and 66% use both %-Cobb correction and fit criteria to evaluate brace adequacy. In contrast, other aspects of brace management demonstrated a high degree of practice variability. This was seen with a radiographic assessment of maturity level, hours prescribed, timing and frequency of radiographic evaluation, the use of nighttime bracing only, and the method and timing of brace discontinuation.
Conclusion
Although there is consensus in brace management amongst SRS members with respect to brace initiation and evaluation of adequacy, there is striking variability in how bracing for AIS is used. This variability may impact the overall efficacy of brace treatment and may be decreased with more robust guidelines from the SRS.
Level of evidence
III.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
Data not available.
Code availability
Code not available, data analyzed with Microsoft Excel 2013.
References
The Scoliosis Research Society. Bracing manual. https://www.srs.org/professionals/online-education-and-resources/srs-bracing-manual. Accessed 1 Oct 2016
Negrini S, Donzelli S, Aulisa AG et al (2018) 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 13:3–51
Weinstein SL, Dolan LA, Wright JG et al (2013) Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 369(16):1512–1521
Emans JB, Bancel P, Hall JE et al (1986) The Boston Bracing System for idiopathic scoliosis. Follow-up results in 295 patients. Spine (Phila PA 1976) 11(8):792–801
Goldberg CJ, Moore DP, Fogarty EE et al (2001) Adolescent idiopathic scoliosis: the effect of brace treatment on the incidence of surgery. Spine (Phila Pa 1976) 26(1):42–47
Richards BS, Bernstein RM, D’Amato CR et al (2005) Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine (Phila Pa 1976) 30(18):2068–2075
Luk KDK, Saw LB, Grozman S et al (2014) Assessment of skeletal maturity in scoliosis patients to determine clinical management: a new classification scheme using distal radius and ulna radiographs. Spine J 14(2):315–325
Sanders JO, Khoury JG, Kishan S et al (2008) Predicting scoliosis progression from skeletal maturity: a simplified classification during adolescence. J Bone Jt Surg Am 90:540–553
Katz DE, Herring JA, Browne RH et al (2010) Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Jt Surg Am 92(6):1343–1352
Simony A, Hansen EJ, Christensen SB et al (2016) Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously. Eur Spine J 25(10):3366–3370
Piatoni L, Tello C, Remondino R et al (2018) Quality of life and patient satisfaction in bracing treatment of AIS. Scoliosis Spinal Disord 14(13):26
Funding
There are no sources (including pharmaceutical and industry) to disclose. None of the authors received financial support for the study.
Author information
Authors and Affiliations
Contributions
All listed authors made substantial contributions to this manuscript and were responsible for specific content areas and critical revisions. Furthermore, all listed authors have approved this document as written and agree to be accountable for all aspects of the work. The authors made specific contributions noted as MFH, LD, RH, RA, RD, ED, OL: conception, design, acquisition, and analysis, drafted and critically revised article, approved of and agreed to be accountable to all aspects of the work.
Corresponding author
Ethics declarations
Conflict of interest
Author MH declares that he has no conflicts of interest or competing interests to disclose. Author LAD is a board member of the SOSORT Executive Committee and consultant for Green Sun Medical. Author RAH declares that he has no conflicts of interest or competing interests to disclose. Author RDA declares that he has no conflicts of interest or competing interests to disclose. Author RD is a consultant for Medtronic and DePuy Synthes Spine and received research grants from DePuy Synthes Spine for a separate project. Author ED declares that he has no conflicts of interest or competing interests to disclose. Author OBL declares that he has no conflicts of interest or competing interests to disclose.
Ethics approval
This study was exempt from Institutional Review Board Approval
Consent to participate
Not applicable.
Consent for publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Halsey, M., Dolan, L.A., Hostin, R.A. et al. Scoliosis Research Society survey: brace management in adolescent idiopathic scoliosis. Spine Deform 9, 697–702 (2021). https://doi.org/10.1007/s43390-020-00265-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s43390-020-00265-4