Conservative treatment of adolescent idiopathic scoliosis: the effectiveness of rigid bracing

Abstract

Abstract Background The use of rigid braces and specialized exercises for the treatment of adolescent idiopathic scoliosis (AIS), is the most common non-surgical approach used to prevent curvature progression. The study aims to assess the efficacy of a rigid brace (the Chêneau brace), in conjunction with SEAS (Scientific Exercise Approach to Scoliosis), as a conservative approach to the treatment of AIS. Methods The study involves a retrospective analysis of data collected prospectively from 119 patients with AIS who underwent treatment with the Chêneau brace and SEAS. Patients with AIS were eligible for treatment if they had a Cobb angle between 20° and 40° (at the time of initial treatment) and significant residual spine growth (Risser grade 0–2). It was recommended that patients wear the brace for a minimum of 22 h per day. The effectiveness of the treatment was assessed based on changes in the Cobb angle measurements. To evaluate the patients’ perception of treatment outcomes, the Scoliosis Research Society-22 revised (SRS-22r) was administered before and after treatment. A multivariable logistic regression analysis was used to identify factors that may independently predict treatment success. Results The use of the Chêneau brace, in combination with SEAS gymnastics, was effective for 99 patients (83.2%). Only six patients (5.1%) achieved a Cobb angle of the major curve greater than 45ο. There were no significant differences in treatment success based on the location of the curve. In the group of patients who followed the recommended wearing time for the brace and SEAS exercises, the rate of curvature progression was significantly lower than in the overall group (0% versus 16.8%, p = 0.004), and the group that partially or poorly followed the treatment protocol (0% versus 28%, p < 0.001). Conclusions The SRS-22r showed improvements in satisfaction with treatment from the start to the end of brace use, with an average score of 4.62 ± 0.54. The use of the Chêneau brace in combination with SEAS gymnastics has been shown to reduce the risk of spinal curvature progression in individuals with AIS.

Keywords

• Adolescent idiopathic scoliosis
• Brace treatment
• Chêneau Brace
• Conservative treatment
• SEAS gymnastics
• SRS-22r questionnaire