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Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis p...

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Autores principales: Zaina, Fabio, Cordani, Claudio, Donzelli, Sabrina, Lazzarini, Stefano Giuseppe, Arienti, Chiara, Del Furia, Matteo Johann, Negrini, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688311/
https://www.ncbi.nlm.nih.gov/pubmed/36360400
http://dx.doi.org/10.3390/children9111672
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author Zaina, Fabio
Cordani, Claudio
Donzelli, Sabrina
Lazzarini, Stefano Giuseppe
Arienti, Chiara
Del Furia, Matteo Johann
Negrini, Stefano
author_facet Zaina, Fabio
Cordani, Claudio
Donzelli, Sabrina
Lazzarini, Stefano Giuseppe
Arienti, Chiara
Del Furia, Matteo Johann
Negrini, Stefano
author_sort Zaina, Fabio
collection PubMed
description There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth period. We included randomized controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series addressing the effect of bracing in patients with idiopathic scoliosis during growth with curves ≥40° for the Cobb angle, published from 2000 onwards. Outcome: The percentage of patients with surgery, curves above 45° or 50°, and a Cobb angle change are all included in the study. Nine papers (563 patients, average worst curve of 44.8°) are included: four are retrospective case series, two are retrospective and two are prospective cohort studies, and one is a prospective controlled study. The overall quality was good, with respect to the type of design. A total of 32% of the patients improved, 26% were stable, and 42% worsened. The rate of improvement ranged from 11% to 78%; the rate of worsening ranged from 4% to 64%. There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed.
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spelling pubmed-96883112022-11-25 Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review Zaina, Fabio Cordani, Claudio Donzelli, Sabrina Lazzarini, Stefano Giuseppe Arienti, Chiara Del Furia, Matteo Johann Negrini, Stefano Children (Basel) Review There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth period. We included randomized controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series addressing the effect of bracing in patients with idiopathic scoliosis during growth with curves ≥40° for the Cobb angle, published from 2000 onwards. Outcome: The percentage of patients with surgery, curves above 45° or 50°, and a Cobb angle change are all included in the study. Nine papers (563 patients, average worst curve of 44.8°) are included: four are retrospective case series, two are retrospective and two are prospective cohort studies, and one is a prospective controlled study. The overall quality was good, with respect to the type of design. A total of 32% of the patients improved, 26% were stable, and 42% worsened. The rate of improvement ranged from 11% to 78%; the rate of worsening ranged from 4% to 64%. There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed. MDPI 2022-10-31 /pmc/articles/PMC9688311/ /pubmed/36360400 http://dx.doi.org/10.3390/children9111672 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Zaina, Fabio
Cordani, Claudio
Donzelli, Sabrina
Lazzarini, Stefano Giuseppe
Arienti, Chiara
Del Furia, Matteo Johann
Negrini, Stefano
Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title_full Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title_fullStr Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title_full_unstemmed Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title_short Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review
title_sort bracing interventions can help adolescents with idiopathic scoliosis with surgical indication: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688311/
https://www.ncbi.nlm.nih.gov/pubmed/36360400
http://dx.doi.org/10.3390/children9111672
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