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Web End = Eur Spine J (2016) 25:30883094 DOI 10.1007/s00586-015-4372-5
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Web End = ORIGINAL ARTICLE
Rib-vertebral angle measurements predict brace treatment outcome in Risser grade 0 and premenarchal girls with adolescent idiopathic scoliosis
Xu Sun1,4 Qi Ding2 Shifu Sha1 Saihu Mao1 Feng Zhu1,4 Zezhang Zhu1,4
Bangping Qian1 Bin Wang1 Jack C. Y. Cheng3,4 Yong Qiu1,4
Received: 26 August 2015 / Revised: 26 December 2015 / Accepted: 28 December 2015 / Published online: 23 January 2016 Springer-Verlag Berlin Heidelberg 2016
AbstractPurpose 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 signicantly higher in patients with initial RVA difference (RVAD) C20 versus \20, or convex
RVA (CRVA) B68 versus [68. From brace initiation to the latest follow-up, CRVA was found to be signicantly 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 C20 and CRVA B68 at brace initiation and at each follow-up were signicantly associated with curve progression.
Conclusions The initial RVAD C20 and CRVA B68
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.
Keywords Adolescent idiopathic scoliosis Rib
vertebral angle difference Convex rib-vertebral angle
Brace treatment Curve progression
Introduction
Bracing is commonly used for managing skeletally immature patients with mild to moderate adolescent idiopathic scoliosis...