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Can we predict the behavior of the scoliotic curve after bracing in adolescent idiopathic scoliosis? Τhe prognostic value of apical vertebra rotation

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Abstract

Purpose

We aimed to recognize radiographic and clinical prognostic factors of scoliotic curve behaviour after bracing.

Methods

Our prognostic study was based on the 25 years outcomes of a Boston braced AIS cohort between 1978 and 1993 that were previously reported. All patients were followed-up during bracing, at short term and 25 years post-bracing. We evaluated the impact of socio-demographic, clinical and radiological parameters on the loss of curve correction after bracing.

Results

Seventy-seven patients were reevaluated at 25 years post-brace. The mean scoliotic curve was significantly increased after bracing until the 25 years follow-up (p < 0.001). The mean loss of curve correction between the end of bracing and long-term follow-up was independent on the curve type, apical vertebra, premenarcheal status at bracing, time and duration of bracing, Cobb angle before or after bracing. The mean apical vertebral rotation after bracing was significantly related to the loss of curve correction (Spearman ρ = 0.2, p = 0.049). Apical vertebral rotation (Perdriolle method) greater than 20° post-bracing had a three times higher chance of progression > 5° compared with lesser apical vertebral rotation (OR 3.071, CI 0.99–9.51). The rotation of the apical vertebra, type and magnitude of the scoliotic curve after bracing explained 27.4% of the variance in the loss of curve correction post-bracing (R square = 0.274, p < 0.001).

Conclusion

A scoliotic curve is expected to lose some correction after bracing. The apical vertebral rotation post-bracing mainly affected the long-term curve behaviour. Adolescents with apical vertebral rotation greater than 20° after bracing may need further attention.

Level of evidence

Prognostic study, Level II

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Ring Road Efkarpia, 56403, Thessaloniki, Greece

    Eustathios Kenanidis, Michael Potoupnis & Eleftherios Tsiridis

  2. Center of Orthopaedics and Regenerative Medicine (C.O.RE.), Center of Interdisciplinary Research and Innovation (C.I.R.I.), Balkan Center, Aristotle University Thessaloniki, Buildings A and B, 10th km Thessaloniki-Thermi Rd, P. O. Box 8318, 57001, Thessaloniki, Greece

    Eustathios Kenanidis, Theodosios Stamatopoulos, Kleoniki I. Athanasiadou, Aikaterini Voulgaridou, Stavros Pellios, Panagiotis Anagnostis, Michael Potoupnis & Eleftherios Tsiridis

Authors
  1. Eustathios Kenanidis
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  2. Theodosios Stamatopoulos
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  3. Kleoniki I. Athanasiadou
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  4. Aikaterini Voulgaridou
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  5. Stavros Pellios
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  6. Panagiotis Anagnostis
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  7. Michael Potoupnis
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  8. Eleftherios Tsiridis
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Contributions

EK made substantial contributions to the conception and design of the work, the acquisition, analysis and interpretation of data, drafted the work or revised it critically for important intellectual content, approved the version to be published. TS drafted the work and revised it critically for important intellectual content, approved the version to be published. KIA drafted the work and revised it critically for important intellectual content, approved the version to be published. ΑV made substantial contributions to the acquisition, analysis and interpretation of data. SP drafted the work and revised it critically for important intellectual content, approved the version to be published. PA approved the version to be published, made substantial contributions to the analysis and interpretation of data. MP approved the version to be published, ensured that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. ET approved the version to be published, ensured that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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The authors declare that they have no conflict of interest.

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This study was performed after obtaining approval by our Institutional Review Board.

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Informed consent was obtained by all patients.

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Kenanidis, E., Stamatopoulos, T., Athanasiadou, K.I. et al. Can we predict the behavior of the scoliotic curve after bracing in adolescent idiopathic scoliosis? Τhe prognostic value of apical vertebra rotation. Spine Deform 9, 91–98 (2021). https://doi.org/10.1007/s43390-020-00184-4

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  • DOI: https://doi.org/10.1007/s43390-020-00184-4

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