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Efficacy of bracing in early infantile scoliosis: a 5-year prospective cohort shows that idiopathic respond better than secondary—2021 SOSORT award winner

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Abstract

Purpose

In conservative early onset scoliosis treatment, interest in bracing is growing because repeated general anaesthesia (required by casting) has been questioned for possible brain damages. We aimed to check the results in the medium term of bracing, comparing idiopathic (IIS) to secondary (SIS) infantile scoliosis.

Methods

We performed a retrospective study in a consecutive prospective cohort. Inclusion criteria were: discovery of scoliosis and bracing below age 3; exclusion criteria: previous spine surgery, less than three consultations. We considered the following results: full (< 20° Cobb) and partial (< 30°) success; hold-up (progression < 5° but curve > 29°); partial (progression > 5°) and full (fusion) failure; statistics: ANOVA for repeated measures; linear mixed effect model with Cobb angle (dependent), time and diagnosis (independent) variables.

Results

We included 34 infants (16 IIS and 18 SIS) of age 1·10 ± 0·10 (years·months), 44 ± 17° curves, 27 ± 10° rib vertebral angle difference, average observation 5·05 ± 3·03 years. We found progressive improvement of IIS and stability of SIS patients. Six IIS (37.5%) and one SIS (6%) reached brace weaning before puberty with 13 ± 5° (improvement 61 ± 15%, p < 0.001), after 4·11 ± 3·07 years of treatment. Three patients were fused, one IIS (6%) and two SIS (11%). Two IIS patients also reached end-of-growth with 18° (start 40° at 1·03 years) and 20° (start 32° at 2·12 years), respectively.

Conclusion

Bracing shows promising results in the medium term for high-degree IIS, with very few hold-ups (19%) and failures (12%). Conversely, failures prevail for SIS (full 11%), even if the partial failure (39%) is still a time-buying strategy.

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Availability of data and material

Data are available at the authors upon request.

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Funding

The authors did not receive support from any organisation for the submitted work.

Author information

Authors and Affiliations

  1. Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, Milan, Italy

    S. Negrini

  2. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    S. Negrini & F. Negrini

  3. ISICO (Italian Scientific Spine Institute), Milan, Italy

    S. Donzelli, G. Jurenaite & F. Zaina

Authors
  1. S. Negrini
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  2. S. Donzelli
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  3. G. Jurenaite
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  4. F. Negrini
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  5. F. Zaina
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Contributions

SN contributed to conception of the study, data collection, paper writing and approval; SD contributed to statistical analysis, data collection, paper correction and approval; GJ, FN and FZ contributed to data collection, paper correction and approval.

Corresponding author

Correspondence to F. Negrini.

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Conflict of interest

SN owns stock of ISICO; the other authors have no relevant financial or non-financial interests to disclose.

Consent to participate

All parents provided written consent to an anonymous retrospective analysis of their children’s clinical data.

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The local Ethical Committee provided consent to the study.

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Appendix

Appendix

See Table 4.

Table 4 STROBE Statement—checklist of items that should be included in reports of observational studies
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Negrini, S., Donzelli, S., Jurenaite, G. et al. Efficacy of bracing in early infantile scoliosis: a 5-year prospective cohort shows that idiopathic respond better than secondary—2021 SOSORT award winner. Eur Spine J 30, 3498–3508 (2021). https://doi.org/10.1007/s00586-021-06889-y

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  • DOI: https://doi.org/10.1007/s00586-021-06889-y

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