The efficacy of Schroth exercises combined with the Chêneau brace for the treatment of adolescent idiopathic scoliosis: a retrospective controlled study.

PURPOSE: We aimed to determine the global effects of the Chêneau brace combined with Schroth exercises on adolescent idiopathic scoliosis (AIS). METHODS: We analyzed 192 patients with AIS who underwent the Chêneau brace treatment alone or combined with Schroth best practice (SBP) from June 2013 to October 2019. There were 138 patients in the Brace group and 54 patients in the Brace + SBP group. Radiographs were obtained at various treatment durations. Answers to the health-related quality of life (HRQoL) questionnaire were recorded before the intervention and at the time of treatment wean. RESULTS: The Cobb angle (-3.55°; p < 0.001) and C7-CSVL (-3.03 mm; p < 0.001) significantly decreased in the Brace + SBP group. Thoracic kyphosis (TK) decreased in both the Brace + SBP group (-1.85°; p = 0.0152) and the Brace group (-5.06; p < 0.001). Changes before and after treatment of TK were significantly different between groups (p < 0.001). The 22-item Scoliosis Research Society function score, self-image, mental health, and EuroQol 5-Dimension scores were significantly higher in the Brace + SBP group. The satisfaction score was higher in the Brace + SBP group (3.77 ± 0.63 vs. 3.13 ± 0.79; p < 0.001). CONCLUSIONS: Compared to bracing alone, the Schroth exercises plus bracing had a better effect on coronal balance. Schroth exercises improve flatback deformity caused by bracing and positively influence the HRQoL in AIS patients who received the Chêneau brace treatment.Implications for RehabilitationBracing and physiotherapy are common treatments for adolescent idiopathic scoliosis (AIS).The Chêneau brace treatment causes flatback deformity and muscle stiffness in AIS patients.The Schroth method helps patients increase muscle strength, halt curve progression, increase vital capacity, and maintain improved posture.The Schroth exercises could improve flatback deformity caused by bracing and positively influence the health-related quality of life in AIS patients who received the Chêneau brace treatment.

A nomogram for predicting reduction loss risk after locking plate fixation for proximal humeral fractures.

PURPOSE: The purpose of our study was to determine the risk factors for reduction loss in patients with proximal humeral fractures after locking plate fixation and establish a nomogram prediction model. METHODS: We retrospectively analyzed the clinical data of proximal humeral fractures patients who had been surgically treated for locking plate in our institution from January 2016 to December 2018. Perioperative information was obtained through the electronic medial record system, univariate and multivariate analyzes were performed to determine the risk factors of reduction loss, and a nomogram model was constructed to predict the risk of reduction loss. The predictive performance and consistency of the model were evaluated by the consistency coefficient (C-index) and the calibration curve, respectively. RESULTS: 115 patients were finally enrolled in our study. Multivariate analysis results showed that age, fracture classification, medial comminution, and calcar screw status were independent risk factors for reduction loss. The accuracy of the contour map for predicting transfusion risk was 0.944. CONCLUSION: We found a correlation between reduction loss and age, fracture classification, medial comminution, and calcar screw status after locking plate fixation for proximal humeral fractures patients. Our nomogram is helpful for clinicians to identify high-risk patients, early intervention and reduce the incidence of reduction loss.

Nomograms Predict Overall Survival and Cancer-Specific Survival in Patients with Fibrosarcoma: A SEER-Based Study.

PURPOSE: Due to the rarity, it is difficult to predict the survival of patients with fibrosarcoma. This study aimed to apply a nomogram to predict survival outcomes in patients with fibrosarcoma. METHODS: A total of 2235 patients with diagnoses of fibrosarcoma were registered in the Surveillance, Epidemiology, and End Results database, of whom 663 patients were eventually enrolled. Univariate and multivariate Cox analyses were used to identify independent prognostic factors. Nomograms were constructed to predict 3-year and 5-year overall survival and cancer-specific survival of patients with fibrosarcoma. RESULTS: In univariate and multivariate analyses of OS, age, sex, race, tumor stage, pathologic grade, use of surgery, and tumor size were identified as independent prognostic factors. Age, sex, tumor stage, pathologic grade, use of surgery, and tumor size were significantly associated with CSS. These characteristics were further included to establish the nomogram for predicting 3-year and 5-year OS and CSS. For the internal validation of the nomogram predictions of OS and CSS, the C-indices were 0.784 and 0.801. CONCLUSION: We developed the nomograms that estimated 3-year and 5-year OS and CSS. These nomograms not only have good discrimination performance and calibration but also provide patients with better clinical benefits.

The Role of Unilateral Balloon Kyphoplasty for the Treatment of Patients with OVCFS: A Systematic Review and Meta-Analysis.

BACKGROUND: An increasing number of studies have been conducted to apply unilateral balloon kyphoplasty in the treatment of ostroporotic vertebral compression fractures (OVCFs). However, the efficacy and safety of unilateral kyphoplasty and whether a unilateral or a bilateral approach is superior is controversial. OBJECTIVES: The purpose of this study was to evaluate the role of unilateral balloon kyphoplasty and use meta-analysis to compare the efficacy and safety of unilateral and bilateral kyphoplasty in patients with OVCFs. STUDY DESIGN: A systematic literature search was conducted from 1970 to April 2017 using Medline database and the Cochrane Central Register of Controlled Trials. Articles were limited to those published in English. Randomized controlled trials and nonrandomized comparative studies were also included. SETTING: The following search terms were used: "osteoporotic vertebral compression fractures," or "OVCF," and "unilateral kyphoplasty," or "unipedicular approach," or "single balloon kyphoplasty," or "one balloon kyphoplasty." A comprehensive search of reference lists of retrieved articles and previous published reviews was also performed to ensure inclusion of all possible studies. METHODS: All potential articles were independently reviewed by 2 investigators for inclusion into the final analysis. MINORS score was used for nonrandomized studies, and Detsky quality index was applied for prospective randomized controlled trials. Systematic review and meta-analysis was performed for the included studies. RESULTS: After unilateral balloon kyphoplasty the mean postoperative visual analog score (VAS) was from 1.74 to 4.77, mean postoperative kyphotic angle was from 5.9º to 11.22º, and complications involving cement leaks was from 6.8 to 21.9% or adjacent level fractures was from 0 to 5.6%). Unilateral kyphoplasty had significantly lower operative time, and less bone cement volume; however, the postoperative VAS, Oswestry Disability Index (ODI), vertebral height restoration rate, and cement leakage and adjacent vertebral fracture rate, were similar to bilateral kyphoplasty. LIMITATIONS: Only 6 randomized controlled trials and 3 retrospective comparative studies were selected for analysis. Heterogeneity was detected among the studies when we pooled the outcomes. CONCLUSIONS: Based on the available evidence, the clinical and radiological results of unilateral balloon kyphoplasty were as good as those of bilateral balloon kyphoplasty for the treatment of OVCFs. And unilateral kyphoplasty had advantages in terms of operation time, radiation exposure, and cost. KEY WORDS: Unilateral balloon kyphoplasty, bilateral balloon kyphoplasty, osteoporotic vertebral compression fractures, complications of balloon kyphoplasty, meta-analysis.