European Spine Journal

, Volume 25, Issue 10, pp 3088–3094 | Cite as

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

  • Xu Sun
  • Qi Ding
  • Shifu Sha
  • Saihu Mao
  • Feng Zhu
  • Zezhang Zhu
  • Bangping Qian
  • Bin Wang
  • Jack C. Y. Cheng
  • Yong QiuEmail author
Original Article



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) ≥20° versus <20°, or convex RVA (CRVA) ≤68° versus >68°. 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 ± 10° to 29 ± 8°) yet a decreasing trend for CRVA (from 68 ± 6° to 60 ± 7°) 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 ≥20° and CRVA ≤68° at brace initiation and at each follow-up were significantly associated with curve progression.


The initial RVAD ≥20° and CRVA ≤68° 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.


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



We thank Zhonghui Chen, Xi Chen, and Changzhi Du for their assistance in data analyses.

Compliance with ethical standards

Conflict of interest


Ethical approval

This study was performed under the approval from the Ethics Committee of our hospital.

Sources of support

This work was supported by the Development Project of Nanjing Science and Technology Commission and Foundation (Grant No. 201402028), the Key Project of Medical Science and Technology Development Foundation, Nanjing Department of Health (Grant No. YKK14053), and the National Natural Science Foundation of China (Grant No. 81301603).


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Xu Sun
    • 1
    • 4
  • Qi Ding
    • 2
  • Shifu Sha
    • 1
  • Saihu Mao
    • 1
  • Feng Zhu
    • 1
    • 4
  • Zezhang Zhu
    • 1
    • 4
  • Bangping Qian
    • 1
  • Bin Wang
    • 1
  • Jack C. Y. Cheng
    • 3
    • 4
  • Yong Qiu
    • 1
    • 4
    Email author
  1. 1.Department of Spine Surgery, The Affiliated Drum Tower HospitalMedical School of Nanjing UniversityNanjingChina
  2. 2.Department of Orthopaedic SurgeryLuan Affiliated Hospital of Anhui Medical UniversityLuanChina
  3. 3.Department of Orthopaedics and TraumatologyChinese University of Hong KongHong KongChina
  4. 4.The Joint Scoliosis Research Center of Nanjing University and Chinese University of Hong KongNanjingChina

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