TY  - JOUR
T1  - Brace Wear Control of Curve Progression in Adolescent Idiopathic Scoliosis
AU  - Herring, J. Anthony
AU  - Katz, Donald E.
AU  - Browne, Richard H.
AU  - Kelly, Derek M.
AU  - Birch, John G.
Y1  - 2010/11/03
N1  - 
JO  - The Journal of Bone & Joint Surgery
SP  - 2616
EP  - 2617
VL  - 92
IS  - 15
N2  - 
We began this study with true uncertainty regarding the effectiveness of bracing and only concluded that bracing altered progression when we discovered quite complex positive correlations between treatment and outcome. Many studies have supported the finding that curves progress most during the adolescent growth spurt and that closure of the triradiate cartilage is a valid indicator of a decline in the growth velocity curve. If bracing were ineffective, the least evident correlation should be in the patients entering treatment with an open triradiate cartilage. We found, to the contrary, that these rapidly growing adolescents had the strongest correlation between curve control and hours of brace wear. We then dissected out the time of brace wear compared with lack of curve progression and found that night wear, which most patients find the most tolerable, had the least correlation with successful treatment. In the group with an open triradiate cartilage, the greatest effective wear occurred when the patient wore the brace while upright, with wear to school and after school being the most important. We also looked at those with closed triradiate cartilage at the time of presentation and found a clear dose-response curve with a different slope, representing the less progressive nature of scoliosis at this growth stage. The graphs for time of wear likewise had a different slope but demonstrated the same relationship, with day wear being more important than night wear. In other words, we found consistent relationships between hours of wear and scoliosis control through multiple analyses with different variables.

SN  - 0021-9355
M3  - doi: 
UR  - http://dx.doi.org/
ER  -