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Low body mass index can be predictive of bracing failure in patients with adolescent idiopathic scoliosis: a retrospective study

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Abstract

Purposes

To determine the relationship between low body mass index (BMI) and the outcome of brace treatment in patients with adolescent idiopathic scoliosis (AIS).

Methods

350 braced female AIS patients were included in this study. The baseline characteristics of the patient were recorded at their first visit, including age, Risser sign, digital skeletal age, BMI, curve pattern, and curve magnitude. Underweight was defined as lower than the 5th percentile of the sex- and age-specific BMI. The treatment was considered as a failure if the curve progressed more than 5°, or if patients underwent surgery. According to the final outcome of brace treatment, the cohort was divided into the success group and the failure group. A logistic regression model was created to determine the independent predictors of the bracing outcome.

Results

24.5% (86/350) of the patients were identified as underweight at their initial visit, which was significantly higher than the rate of 13.1% (46/350) at the final follow-up (p < 0.001). At the initial visit of the patients, the rate of underweight was 17.6% (45/255) in the success group, which was significantly lower than the rate of 43.1% (41/95) in the failure group (p < 0.001). Logistic regression analysis showed that low BMI was significantly associated with bracing failure (p < 0.001).

Conclusion

The low BMI could be predictive of bracing failure in AIS patients, which should be taken into account when surgeons prescribe brace treatment to such patients.

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References

  1. Clin J, Aubin CE, Sangole A, Labelle H, Parent S (2010) Correlation between immediate in-brace correction and biomechanical effectiveness of brace treatment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 35:1706–1713

    Article  Google Scholar 

  2. Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL (2007) A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity. Spine (Phila Pa 1976) 32:2198–2207

    Article  Google Scholar 

  3. Sun X, Liu WJ, Xu LL, Ding Q, Mao SH, Qian BP, Zhu ZZ, Qiu Y (2013) Does brace treatment impact upon the flexibility and the correctability of idiopathic scoliosis in adolescents? Eur Spine J 22:268–273

    Article  PubMed  Google Scholar 

  4. Xu L, Qiu X, Sun X, Mao S, Liu Z, Qiao J, Qiu Y (2011) Potential genetic markers predicting the outcome of brace treatment in patients with adolescent idiopathic scoliosis. Eur Spine J 20:1757–1764

    Article  PubMed  PubMed Central  Google Scholar 

  5. Richards BS, Bernstein RM, D’Amato CR, Thompson GH (2005) Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine (Phila Pa 1976) 30:2068–2075

    Article  Google Scholar 

  6. Weinstein SL, Dolan LA, Wright JG, Dobbs MB (2013) Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 369:1512–1521

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. 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 Jt Surg Am 76:1207–1221

    Article  CAS  Google Scholar 

  8. Nachemson AL, Peterson LE (1995) Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Jt Surg Am 77:815–822

    Article  CAS  Google Scholar 

  9. Olafsson Y, Saraste H, Soderlund V, Hoffsten M (1995) Boston brace in the treatment of idiopathic scoliosis. J Pediatr Orthop 15:524–527

    Article  CAS  PubMed  Google Scholar 

  10. Matsunaga S, Hayashi K, Naruo T, Nozoe S, Komiya S (2005) Psychologic management of brace therapy for patients with idiopathic scoliosis. Spine (Phila Pa 1976) 30:547–550

    Article  Google Scholar 

  11. Vijvermans V, Fabry G, Nijs J (2004) Factors determining the final outcome of treatment of idiopathic scoliosis with the Boston brace: a longitudinal study. J Pediatr Orthop B 13:143–149

    PubMed  Google Scholar 

  12. Upadhyay SS, Nelson IW, Ho EK, Hsu LC, Leong JC (1995) New prognostic factors to predict the final outcome of brace treatment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 20:537–545

    Article  CAS  Google Scholar 

  13. Xu L, Qin X, Qiu Y, Zhu Z (2016) Initial correction rate can be predictive of the outcome of brace treatment in patients with adolescent idiopathic scoliosis. Clin Spine Surg. doi:10.1097/BSD.0000000000000343

    Google Scholar 

  14. Lou EH, Hill DL, Raso JV, Moreau M, Hedden D (2016) How quantity and quality of brace wear affect the brace treatment outcomes for AIS. Eur Spine J 25:495–499

    Article  PubMed  Google Scholar 

  15. Yamauchi Y, Yamaguchi T, Asaka Y (1988) Prediction of curve progression in idiopathic scoliosis based on initial roentgenograms. A proposal of an equation. Spine (Phila Pa 1976) 13:1258–1261

    Article  CAS  Google Scholar 

  16. Wei-Jun W, Xu S, Zhi-Wei W, Xu-Sheng Q, Zhen L, Yong Q (2012) Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis. Eur Spine J 21:77–83

    Article  PubMed  Google Scholar 

  17. Tarrant RC, Lynch S, Sheeran P, O’Loughlin PF, Harrington M, Moore DP, Kiely PJ (2014) Low body mass index in adolescent idiopathic scoliosis: relationship with pre- and postsurgical factors. Spine 39:140–148

    Article  PubMed  Google Scholar 

  18. Qiu Y, Sun X, Qiu X, Li W, Zhu Z, Zhu F, Wang B, Yu Y, Qian B (2007) Decreased circulating leptin level and its association with body and bone mass in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 32:2703–2710

    Article  Google Scholar 

  19. Shohat M, Shohat T, Nitzan M, Mimouni M, Kedem R, Danon YL (1988) Growth and ethnicity in scoliosis. Acta Orthop Scand 59:310–313

    Article  CAS  PubMed  Google Scholar 

  20. Wang S, Qiu Y, Ma Z, Xia C, Zhu F, Zhu Z (2007) Histologic, risser sign, and digital skeletal age evaluation for residual spine growth potential in Chinese female idiopathic scoliosis. Spine (Phila Pa 1976) 32:1648–1654

    Article  Google Scholar 

  21. Bjure J, Grimby G, Nachemson A (1968) Correction of body height in predicting spirometric values in scoliotic patients. Scand J Clin Lab Invest 21:191–192

    Article  CAS  PubMed  Google Scholar 

  22. Mahajan PB, Purty AJ, Singh Z, Cherian J, Natesan M, Arepally S, Senthilvel V (2011) Study of childhood obesity among school children aged 6–12 years in union territory of puducherry. Indian J Community Med 36:45–50

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wilson AC, Samuelson B, Palermo TM (2010) Obesity in children and adolescents with chronic pain: associations with pain and activity limitations. Clin J Pain 26:705–711

    PubMed  PubMed Central  Google Scholar 

  24. Drummond DS, Rogala EJ (1980) Growth and maturation of adolescents with idiopathic scoliosis. Spine (Phila Pa 1976) 5:507–511

    Article  CAS  Google Scholar 

  25. Hagglund G, Karlberg J, Willner S (1992) Growth in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 17:108–111

    Article  CAS  Google Scholar 

  26. Wang Y, Ge K, Popkin BM (2000) Tracking of body mass index from childhood to adolescence: a 6-year follow-up study in China. Am J Clin Nutr 72:1018–1024

    CAS  PubMed  Google Scholar 

  27. Goodbody CM, Asztalos IB, Sankar WN, Flynn JM (2016) It’s not just the big kids: both high and low BMI impact bracing success for adolescent idiopathic scoliosis. J Child Orthop. doi:10.1007/s11832-016-0763-3

    PubMed  PubMed Central  Google Scholar 

  28. O’Neill PJ, Karol LA, Shindle MK, Elerson EE, BrintzenhofeSzoc KM, Katz DE, Farmer KW, Sponseller PD (2005) Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Jt Surg Am 87:1069–1074

    Article  Google Scholar 

  29. Negrini S, Hresko TM, O’Brien JP, Price N (2015) Recommendations for research studies on treatment of idiopathic scoliosis: Consensus 2014 between SOSORT and SRS non-operative management committee. Scoliosis 10:8

    Article  PubMed  PubMed Central  Google Scholar 

  30. Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O’Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagrasa M, Weiss HR, Zaina F (2012) 2011 SOSORT guidelines: orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 7:3

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant No. 81501849 & No. 81201385).

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Correspondence to Leilei Xu.

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No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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W. Sun and J. Zhou contribute equally to this work.

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Sun, W., Zhou, J., Sun, M. et al. Low body mass index can be predictive of bracing failure in patients with adolescent idiopathic scoliosis: a retrospective study. Eur Spine J 26, 1665–1669 (2017). https://doi.org/10.1007/s00586-016-4839-z

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  • DOI: https://doi.org/10.1007/s00586-016-4839-z

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