Effects of Bracing in Adult With Scoliosis: A Retrospective Study.

ABSTRACT

OBJECTIVE: To assess the effectiveness of bracing in adult with scoliosis. DESIGN: Retrospective cohort study. SETTING: Outpatients followed in 2 tertiary care hospitals. PARTICIPANTS: Adults (N=38) with nonoperated progressive idiopathic or degenerative scoliosis treated by custom-molded lumbar-sacral orthoses, with a minimum follow-up time of 10 years before bracing and 5 years after bracing. Progression was defined as a variation in Cobb angle ≥10° between the first and the last radiograph before bracing. The brace was prescribed to be worn for a minimum of 6h/d. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Rate of progression of the Cobb angle before and after bracing measured on upright 3-ft full-spine radiographs. RESULTS: At the moment of bracing, the mean age was 61.3±8.2 years, and the mean Cobb angle was 49.6°±17.7°. The mean follow-up time was 22.0±11.1 years before bracing and 8.7±3.3 years after bracing. For both types of scoliosis, the rate of progression decreased from 1.28°±.79°/y before to .21°±.43°/y after bracing (P<.0001). For degenerative and idiopathic scoliosis, it dropped from 1.47°±.83°/y before to .24°±.43°/y after bracing (P<.0001) and .70°±.06°/y before to .24°±.43°/y after bracing (P=.03), respectively. CONCLUSIONS: For the first time, to our knowledge, this study suggests that underarm bracing may be effective in slowing down the rate of progression in adult scoliosis. Further prospective studies are needed to confirm these results.