Skip to main content

Advertisement

SpringerLink
Log in

Comparative multifactorial analysis of the effects of idiopathic adolescent scoliosis and Scheuermann kyphosis on the self-perceived health status of adolescents treated with brace

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Bracing is the most effective non-operative treatment for mild progressive spinal deformities in adolescence but it has shown a considerable impact on several aspects of adolescents’ functioning. This cross-sectional study investigated the self-perceived health status of adolescents with the two most common deformities, treated with body orthosis. Seventy-nine adolescents with spinal deformities (idiopathic adolescent scoliosis, thoracic Scheuermann kyphosis) and 62 adolescents without spinal deformities were asked to complete the Quality of Life profile for Spine Deformities Instrument. This study showed that adolescents with deformities are significantly less likely to have back pain in training than controls, but more likely to have difficulty in forward bending, and in the most common daily activities while in brace. These individuals claim they wake up because of back pain and feel quite nervous with the external appearance of their body. These patients face often problems with their relations with friends, while they reported difficulties in getting up from bed and sleep at night more often than their counterparts without deformities. As they grow older, patients feel increasing ashamed of their body, as they are more concerned about the future effect of the deformity on their body. As the bracing time increases, patients have much more probability than controls to get low back pain. Girls with deformity have a higher probability than boys to get low back pain while working in the house and while training. Individuals with larger spinal curvatures have more difficulties in bending and increased incidence of back pain than their counterparts with smaller curvatures. Psychological reasons associated mainly with relations at school and back pain are the main causes for low compliance in adolescents with spinal deformities treated with body orthosis. Careful instructions for all individuals who will undergo brace therapy, psychological support for all patients who develop psychological reactions and physical training particularly for older girls should be recommended to increase bracing compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Apter A, Morein G, Munitz H, Tyano S, Maoz B, Wijsenbeek H (1978) The psychosocial sequelae of the Milwaukee brace in adolescent girls. Clin Orthop 131:156–159

    PubMed  Google Scholar 

  2. Beaton DE, Bombardier C (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191

    Article  PubMed  CAS  Google Scholar 

  3. Blount WP (1973) Principles of treatment of scoliosis and round back with the Milwaukee brace. Isr J Med Sci 9:745–754

    PubMed  CAS  Google Scholar 

  4. Bowen JR, Keeler KA, Pelegie S (2001) Adolescent idiopathic scoliosis managed by a night time bending brace. Orthopedics 24:967–970

    PubMed  CAS  Google Scholar 

  5. Carr WA, Moe JH, Winter RB, et al (1980) Treatment of idiopathic scoliosis in the Milwaukee brace. J Bone Joint Surg Am 62:599–612

    PubMed  CAS  Google Scholar 

  6. Cholewicki J, Alvi K, Silfies SP, Bartolomei J (2003) Comparison of motion restriction and trunk stiffness provided by three thoracolumbosacral orthoses (TLSO). J Spinal Disord 16:461–468

    Article  Google Scholar 

  7. Clayson D, Luz-Alterman S, Cataletto MM, Levine DB (1987) Long-term psychosocial sequelae of surgically versus nonsurgically treated scoliosis. Spine 12: 983–986

    Article  PubMed  CAS  Google Scholar 

  8. Climent JM, Sanchez J, the Group for the study of quality of life in spine deformities (1999) Impact of the type of brace on the quality of life of adolescents with spine deformities. Spine 24:1903–1913

    Google Scholar 

  9. DiRaimondo CV, Green NE (1988 ) Brace wear compliance in patients with adolescent idiopathic scoliosis. J Pediatr Orthop 8:143–146

    PubMed  CAS  Google Scholar 

  10. Edmosson AS, Morris JT (1977) Follow-up study of Milwaukee brace treatment in patients with idiopathic scoliosis. Clin Orthop Relat Res 126:58–61

    Google Scholar 

  11. Emans JB, KaelinA, Bancel P, et al (1986) The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine 11:792–802

    Article  PubMed  CAS  Google Scholar 

  12. Fällström K, Cochran T, Nachemson A (1986) Long-term effects on personality development in patients with adolescent idiopathic scoliosis. Influence of type of treatment. Spine 11:756–758

    Google Scholar 

  13. Gratz RR, Papalia-Finlay D (1984) Psychosocial adaptation to wearing the Milwaukee brace for scoliosis. J Adolesc Health Care 5:237–242

    Article  PubMed  CAS  Google Scholar 

  14. Heckman SLA, Nash CL Jr, Drotar DD, Hall TW (1977) Emotional adjustment in scoliosis. Clin Orthop 125:145–150

    Google Scholar 

  15. Helfenstein A, Lankes M, Ohlert K, Varoga D, Hahne H, Urlich H, Hassenpfulg J (2006) The objective determination of compliance in treatment of adolescent idiopathic scoliosis with spinal orthsis. Spine 31:339–344

    Article  PubMed  Google Scholar 

  16. Houghton GR, McInerney A, Tew A (1997) Brace compliance in adolescent idiopathic scoliosis. J Bone Joint Surg Br 69:852

    Google Scholar 

  17. Jensen AR (1958) The Maudley personality inventory. Acta Psychol (Amst) 14:314–325

    Article  Google Scholar 

  18. Kahanovitz N, Snow B, Pinter I (1984) The comparative results of psychologic testing in scoliosis patients treated with electrical stimulation or bracing. Spine 9:442–445

    Article  PubMed  CAS  Google Scholar 

  19. Kahanovitz N, Weiser S (1989) The psychological impact of idiopathic scoliosis on the adolescent female: a preliminary multi-center study. Spine 14:483–485

    Article  PubMed  CAS  Google Scholar 

  20. Karol L (2001) Effectiveness of bracing in male patients with idiopathic scoliosis. Spine 26:2001–2005

    Article  PubMed  CAS  Google Scholar 

  21. Katz DE, Richards S, Browne RH, Herring JA (1997) A comparison between the Boston brace and the Charleston bending brace in adolescent idiopathic scoliosis. Spine 22:1302–1312

    Article  PubMed  CAS  Google Scholar 

  22. Keiser RP, Shufflebarger HL (1976) The Milwaukee brace in idiopathic scoliosis: evaluation of 123 completed cases. Clin Orthop Relat Res 118:19–24

    PubMed  Google Scholar 

  23. Korovessis P, Koureas G, Papazisis Z (2004) Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Disord Tech 17(1):33–40

    Article  PubMed  Google Scholar 

  24. Korovessis P, Koureas G, Zacharatos S, Papazisis Z (2005) Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis. Spine 30:247–255

    Article  PubMed  Google Scholar 

  25. Korovessis P, Kyrkos Ch, Piperos G, Soukakos P (2000) Effects of thoracolumbosacral orthosis on spinal deformities, trunk asymmetry and frontal lower rib cage in adolescent idiopathic scoliosis. Spine 25:2064–2071

    Article  PubMed  CAS  Google Scholar 

  26. Korovessis P, Stamatakis M (1996) Prediction of scoliotic Cobb angle with the use of the scoliometer. Spine 21:1661–1666

    Article  PubMed  CAS  Google Scholar 

  27. Krag MH, Fox J, Haugh LD (2003) Comparison of three lumbar orthoses using motion assessment during tusk performance. Spine 28:2359–2367

    Article  PubMed  Google Scholar 

  28. Lindeman M, Behm K (1999) Cognitive strategies and self-esteemas predictors of brace- wear noncompliance in patient idiopathic scoliosis and kyphosis. J Pediatr Orthop 19:493–499

    Article  PubMed  CAS  Google Scholar 

  29. Lonstein JE, Winter RB (1994) The Milwaukee brace for the treatment of adolescent idiopathic scoliosis: a review of one thousand and twenty patients. J Bone Joint Surg [Am] 76:1207–1221

    CAS  Google Scholar 

  30. MacLean WE Jr, Green NE, Pierre CB, Ray DC (1989) Stress and coping with scoliosis: psychological effect on adolescents and their families. J Pediatr Orthop 9:257–261

    PubMed  Google Scholar 

  31. Matsunaga S, Sakou T, Nozoe S (1997) Psycological effects of brace therapy on patients with idiopathic scoliosis. J Orthop Sci 2:391–395

    Article  Google Scholar 

  32. Matsunaga S, Hayashi K, Nauro T, Nozoe S, Komiya S (2005) Psychologic management of brace therapy for patients with idiopathic scoliosis. Spine 30:547–550

    Article  PubMed  Google Scholar 

  33. Moe JH, Kettleson DN (1970) Idiopathic scoliosis. Analysis of curve patterns and the preliminary results of Milwaukee-brace treatment in one hundred sixty-nine patients. J Bone Joint Surg Am 52:1509–1533

    PubMed  CAS  Google Scholar 

  34. Myers BA, Friedman SB, Weiner IB (1970) Coping with a chronic disability: psychosocial observations of girls with scoliosis treated with the Milwaukee brace. Am J Dis Child 120:175–181

    PubMed  CAS  Google Scholar 

  35. Nicholson GP, Ferguson-Pell MW, Smith K, Edgar M, Morley T (2003) The objective measurmentof spinal orthosis use for the treatment of adolescent idiopathic scoliosis. Spine 28:2243–2250

    Article  PubMed  CAS  Google Scholar 

  36. Sapountzi-Krepia D, Valavanis J, Panteleakis G, et al (2001) Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment. J Adv Nurs 35:683–690

    Article  PubMed  CAS  Google Scholar 

  37. Scoloveno MA, Yarcheski A, Mahon NE (1990) Scoliosis treatment effects on selected variables among adolescents. West J Nurs Res 12:601–618

    Article  PubMed  CAS  Google Scholar 

  38. Takemitsu M, Bowen JR, Rahman T, Glutting JJ, Scott CB (2004) Compliance monitoring of barce treatment for patients with idiopathic scoliosis. Spine 29:2070–2074

    Article  PubMed  Google Scholar 

  39. Walker C (2003) Research on psychological aspects of scoliosis/kyphosis. J Prosthet Orthot 4S:53–56

    Article  Google Scholar 

  40. Wikcers FC, Bunch WH, Barnett PM (1977) Psychological factors in failure to wear the Milwaukee brace for treatment of idiopathic scoliosis. Clin Orthop 126:62–66

    Google Scholar 

  41. Willers U, Normelli H, Aaro S, et al (1993) Long-term results of Boston brace treatment on vertebral rotation in idiopathic scoliosis. Spine 18:432–435

    Article  PubMed  CAS  Google Scholar 

  42. Wysocki T, Harris M, Greco P, et al (1997) Social validity of support group and behavior therapy interventions for families adolescents with insulin-dependent diabetes mellitus. J Pediatr Psychol 22:635–649

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, General Hospital “Agios Andreas”, 26224, Patras, Greece

    Panagiotis Korovessis, Spyridon Zacharatos & Georgios Koureas

  2. Orthopaedic Department, University Hospital Riom, 26224, Patras, Greece

    Panagiotis Megas

Authors
  1. Panagiotis Korovessis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Spyridon Zacharatos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgios Koureas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Panagiotis Megas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Panagiotis Korovessis.

Appendix: Items of the quality of life for spine deformities

Appendix: Items of the quality of life for spine deformities

(A) Psychosocial function

  1. 1.

    I leave the house less frequently than I used to

    • Very often

    • Often

    • Sometimes

    • Rarely

    • Never

  2. 2.

    I do not enjoy my weekends

    • Very often

    • Often

    • Sometimes

    • Rarely

    • Never

  3. 3.

    I have lost some friends

    • Many

    • Enough

    • Some

    • A few

    • None

  4. 4.

    I get angry very often

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  5. 5.

    I find it difficult to relate to other people

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  6. 6.

    I have had to give up my favorite pastime

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  7. 7.

    I spend less time than usual with my friends

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

(B) Sleep disturbances

  1. 1.

    I always experience discomfort when getting out of bed

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  2. 2.

    I do not sleep well at night

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  3. 3.

    I find it difficult to fall asleep

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  4. 4.

    Backache wakes me up at night

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

(C) Body image

  1. 1.

    I am ashamed to be seen in a swimsuit

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  2. 2.

    I am ashamed of my body

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  3. 3.

    I feel that I am badly shaped

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  4. 4.

    I worry a lot that my back may affect my life in the future

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

(D) Back flexibility

  1. 1.

    I have difficulty bending forward

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  2. 2.

    I have problems getting dressed

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

  3. 3.

    I find it difficult to pick up things that I have

    • Always

    • Often

    • Sometimes

    • Rarely

    • Never

(E) To evaluate responsiveness

  1. 1.

    Regarding my last medical evaluation with my back specialist, I feel

    • Much better

    • Better

    • The same

    • Worse

    • Much worse

  2. 2.

    My present health status, in general, is

    • Very good

    • Good

    • Fair

    • Poor

    • Very poor

Rights and permissions

Reprints and permissions

About this article

Cite this article

Korovessis, P., Zacharatos, S., Koureas, G. et al. Comparative multifactorial analysis of the effects of idiopathic adolescent scoliosis and Scheuermann kyphosis on the self-perceived health status of adolescents treated with brace. Eur Spine J 16, 537–546 (2007). https://doi.org/10.1007/s00586-006-0214-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-006-0214-9

Keywords

Search

Navigation