Supine Lateral Bending Radiographs Predict the Initial In-brace Correction of the Providence Brace in Patients With Adolescent Idiopathic Scoliosis

Søren Ohrt-Nissen; Dennis W Hallager; Martin Gehrchen; Benny Dahl

doi:10.1097/BRS.0000000000001519

Supine Lateral Bending Radiographs Predict the Initial In-brace Correction of the Providence Brace in Patients With Adolescent Idiopathic Scoliosis

Søren Ohrt-Nissen, Dennis W Hallager, Martin Gehrchen, Benny Dahl

Department of Orthopaedics Surgery

16 Citations (Scopus)

Abstract

STUDY DESIGN: Retrospective, cross-sectional.

OBJECTIVE: To determine the initial curve correction of the providence brace (PB) and to determine to what extend the in-brace Cobb angle corresponds to the curve seen on supine lateral bending radiographs (SLBR).

SUMMARY OF BACKGROUND DATA: SLBR are used to assess curve flexibility in patients undergoing surgical treatment for adolescent idiopathic scoliosis (AIS). A low rate of in-brace correction (IBC) has been associated with a higher risk of curve progression, but to what extent SLBR can be used to predict IBC before initiating bracing treatment is unknown.

METHODS: All patients with AIS treated with the PB from January 1, 2006 to December 31, 2013 with a major curve of 25 to 45 degrees° were included. Cobb angle on SLBR before treatment and on initial standing, in-brace radiograph (IBR) were measured twice for each patient by one observer 30 days apart. Using a repeated measure mixed effect model, mean difference and 95% limits of agreement (LOA) between Cobb angles on each type of radiograph were estimated. Correction index (CI) was calculated as: curve flexibility (%)/curve correction (%).

RESULTS: A total of 127 patients were included. Mean long-standing Cobb angle was 35° (SD: 6°), which was reduced to mean 13° (SD: 8) on IBR (P < 0.05). No difference in curve correction between curve types was found when adjusting for flexibility using correction index (P = 0.77). Overall mean difference between SLBR and IBR was 0.2° (LOA ± 10°). Mean difference for thoracic curves was 0.2° (LOA ± 8°), for thoracolumbar/lumbar curves 0.9° (LOA ± 10°) and for double major curves 0.4° (LOA ± 16).

CONCLUSION: SLBR provide a close estimation to the expected in-brace correction with a mean difference of less than one degree. SLRB could potentially serve as prognostic parameter for curve progression before initiating brace treatment.

LEVEL OF EVIDENCE: 3.

Original language	English
Journal	Spine
Volume	41
Issue number	9
Pages (from-to)	798-802
Number of pages	5
ISSN	0362-2436
DOIs	https://doi.org/10.1097/BRS.0000000000001519
Publication status	Published - May 2016

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Journal Article

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10.1097/BRS.0000000000001519

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@article{fbf3116f8faf48239187c9050d9acbc7,

title = "Supine Lateral Bending Radiographs Predict the Initial In-brace Correction of the Providence Brace in Patients With Adolescent Idiopathic Scoliosis",

abstract = "STUDY DESIGN: Retrospective, cross-sectional.OBJECTIVE: To determine the initial curve correction of the providence brace (PB) and to determine to what extend the in-brace Cobb angle corresponds to the curve seen on supine lateral bending radiographs (SLBR).SUMMARY OF BACKGROUND DATA: SLBR are used to assess curve flexibility in patients undergoing surgical treatment for adolescent idiopathic scoliosis (AIS). A low rate of in-brace correction (IBC) has been associated with a higher risk of curve progression, but to what extent SLBR can be used to predict IBC before initiating bracing treatment is unknown.METHODS: All patients with AIS treated with the PB from January 1, 2006 to December 31, 2013 with a major curve of 25 to 45 degrees° were included. Cobb angle on SLBR before treatment and on initial standing, in-brace radiograph (IBR) were measured twice for each patient by one observer 30 days apart. Using a repeated measure mixed effect model, mean difference and 95% limits of agreement (LOA) between Cobb angles on each type of radiograph were estimated. Correction index (CI) was calculated as: curve flexibility (%)/curve correction (%).RESULTS: A total of 127 patients were included. Mean long-standing Cobb angle was 35° (SD: 6°), which was reduced to mean 13° (SD: 8) on IBR (P < 0.05). No difference in curve correction between curve types was found when adjusting for flexibility using correction index (P = 0.77). Overall mean difference between SLBR and IBR was 0.2° (LOA ± 10°). Mean difference for thoracic curves was 0.2° (LOA ± 8°), for thoracolumbar/lumbar curves 0.9° (LOA ± 10°) and for double major curves 0.4° (LOA ± 16).CONCLUSION: SLBR provide a close estimation to the expected in-brace correction with a mean difference of less than one degree. SLRB could potentially serve as prognostic parameter for curve progression before initiating brace treatment.LEVEL OF EVIDENCE: 3.",

keywords = "Journal Article",

author = "S{\o}ren Ohrt-Nissen and Hallager, {Dennis W} and Martin Gehrchen and Benny Dahl",

year = "2016",

month = may,

doi = "10.1097/BRS.0000000000001519",

language = "English",

volume = "41",

pages = "798--802",

journal = "Spine",

issn = "0362-2436",

publisher = "Lippincott Williams & Wilkins",

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TY - JOUR

T1 - Supine Lateral Bending Radiographs Predict the Initial In-brace Correction of the Providence Brace in Patients With Adolescent Idiopathic Scoliosis

AU - Ohrt-Nissen, Søren

AU - Hallager, Dennis W

AU - Gehrchen, Martin

AU - Dahl, Benny

PY - 2016/5

Y1 - 2016/5

N2 - STUDY DESIGN: Retrospective, cross-sectional.OBJECTIVE: To determine the initial curve correction of the providence brace (PB) and to determine to what extend the in-brace Cobb angle corresponds to the curve seen on supine lateral bending radiographs (SLBR).SUMMARY OF BACKGROUND DATA: SLBR are used to assess curve flexibility in patients undergoing surgical treatment for adolescent idiopathic scoliosis (AIS). A low rate of in-brace correction (IBC) has been associated with a higher risk of curve progression, but to what extent SLBR can be used to predict IBC before initiating bracing treatment is unknown.METHODS: All patients with AIS treated with the PB from January 1, 2006 to December 31, 2013 with a major curve of 25 to 45 degrees° were included. Cobb angle on SLBR before treatment and on initial standing, in-brace radiograph (IBR) were measured twice for each patient by one observer 30 days apart. Using a repeated measure mixed effect model, mean difference and 95% limits of agreement (LOA) between Cobb angles on each type of radiograph were estimated. Correction index (CI) was calculated as: curve flexibility (%)/curve correction (%).RESULTS: A total of 127 patients were included. Mean long-standing Cobb angle was 35° (SD: 6°), which was reduced to mean 13° (SD: 8) on IBR (P < 0.05). No difference in curve correction between curve types was found when adjusting for flexibility using correction index (P = 0.77). Overall mean difference between SLBR and IBR was 0.2° (LOA ± 10°). Mean difference for thoracic curves was 0.2° (LOA ± 8°), for thoracolumbar/lumbar curves 0.9° (LOA ± 10°) and for double major curves 0.4° (LOA ± 16).CONCLUSION: SLBR provide a close estimation to the expected in-brace correction with a mean difference of less than one degree. SLRB could potentially serve as prognostic parameter for curve progression before initiating brace treatment.LEVEL OF EVIDENCE: 3.

AB - STUDY DESIGN: Retrospective, cross-sectional.OBJECTIVE: To determine the initial curve correction of the providence brace (PB) and to determine to what extend the in-brace Cobb angle corresponds to the curve seen on supine lateral bending radiographs (SLBR).SUMMARY OF BACKGROUND DATA: SLBR are used to assess curve flexibility in patients undergoing surgical treatment for adolescent idiopathic scoliosis (AIS). A low rate of in-brace correction (IBC) has been associated with a higher risk of curve progression, but to what extent SLBR can be used to predict IBC before initiating bracing treatment is unknown.METHODS: All patients with AIS treated with the PB from January 1, 2006 to December 31, 2013 with a major curve of 25 to 45 degrees° were included. Cobb angle on SLBR before treatment and on initial standing, in-brace radiograph (IBR) were measured twice for each patient by one observer 30 days apart. Using a repeated measure mixed effect model, mean difference and 95% limits of agreement (LOA) between Cobb angles on each type of radiograph were estimated. Correction index (CI) was calculated as: curve flexibility (%)/curve correction (%).RESULTS: A total of 127 patients were included. Mean long-standing Cobb angle was 35° (SD: 6°), which was reduced to mean 13° (SD: 8) on IBR (P < 0.05). No difference in curve correction between curve types was found when adjusting for flexibility using correction index (P = 0.77). Overall mean difference between SLBR and IBR was 0.2° (LOA ± 10°). Mean difference for thoracic curves was 0.2° (LOA ± 8°), for thoracolumbar/lumbar curves 0.9° (LOA ± 10°) and for double major curves 0.4° (LOA ± 16).CONCLUSION: SLBR provide a close estimation to the expected in-brace correction with a mean difference of less than one degree. SLRB could potentially serve as prognostic parameter for curve progression before initiating brace treatment.LEVEL OF EVIDENCE: 3.

KW - Journal Article

U2 - 10.1097/BRS.0000000000001519

DO - 10.1097/BRS.0000000000001519

M3 - Journal article

C2 - 26909835

SN - 0362-2436

VL - 41

SP - 798

EP - 802

JO - Spine

JF - Spine

IS - 9

ER -

Supine Lateral Bending Radiographs Predict the Initial In-brace Correction of the Providence Brace in Patients With Adolescent Idiopathic Scoliosis

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