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

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Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusions

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.

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Acknowledgments

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

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Authors and Affiliations

  1. Department of Spine Surgery, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road 321, Nanjing, 210008, China

    Xu Sun, Shifu Sha, Saihu Mao, Feng Zhu, Zezhang Zhu, Bangping Qian, Bin Wang & Yong Qiu

  2. Department of Orthopaedic Surgery, Luan Affiliated Hospital of Anhui Medical University, Luan, China

    Qi Ding

  3. Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China

    Jack C. Y. Cheng

  4. The Joint Scoliosis Research Center of Nanjing University and Chinese University of Hong Kong, Nanjing, China

    Xu Sun, Feng Zhu, Zezhang Zhu, Jack C. Y. Cheng & Yong Qiu

Authors
  1. Xu Sun
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  2. Qi Ding
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  3. Shifu Sha
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  4. Saihu Mao
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Corresponding author

Correspondence to Yong Qiu.

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Conflict of interest

None.

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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Sun, X., Ding, Q., Sha, S. et al. Rib-vertebral angle measurements predict brace treatment outcome in Risser grade 0 and premenarchal girls with adolescent idiopathic scoliosis. Eur Spine J 25, 3088–3094 (2016). https://doi.org/10.1007/s00586-015-4372-5

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  • DOI: https://doi.org/10.1007/s00586-015-4372-5

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