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Volume 9
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10.3390/children9111672
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Review

Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review

by
Fabio Zaina
1,
Claudio Cordani
2,
Sabrina Donzelli
1,*,
Stefano Giuseppe Lazzarini
3,
Chiara Arienti
3,
Matteo Johann Del Furia
2 and
Stefano Negrini
2,4
1
ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy
2
IRCCS Istituto Ortopedico Galeazzi, 20157 Milan, Italy
3
IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
4
Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Children 2022, 9(11), 1672; https://doi.org/10.3390/children9111672
Submission received: 31 August 2022 / Revised: 18 October 2022 / Accepted: 25 October 2022 / Published: 31 October 2022
(This article belongs to the Special Issue Evidence on Conservative Treatment and Assessment of Idiopathic Scoliosis and Other Spinal Deformities)
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Abstract

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth period. We included randomized controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series addressing the effect of bracing in patients with idiopathic scoliosis during growth with curves ≥40° for the Cobb angle, published from 2000 onwards. Outcome: The percentage of patients with surgery, curves above 45° or 50°, and a Cobb angle change are all included in the study. Nine papers (563 patients, average worst curve of 44.8°) are included: four are retrospective case series, two are retrospective and two are prospective cohort studies, and one is a prospective controlled study. The overall quality was good, with respect to the type of design. A total of 32% of the patients improved, 26% were stable, and 42% worsened. The rate of improvement ranged from 11% to 78%; the rate of worsening ranged from 4% to 64%. There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed.
Keywords: idiopathic scoliosis; brace; surgery; conservative treatment; rehabilitation; pediatrics; systematic review idiopathic scoliosis; brace; surgery; conservative treatment; rehabilitation; pediatrics; systematic review

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MDPI and ACS Style

Zaina, F.; Cordani, C.; Donzelli, S.; Lazzarini, S.G.; Arienti, C.; Del Furia, M.J.; Negrini, S. Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review. Children 2022, 9, 1672. https://doi.org/10.3390/children9111672

AMA Style

Zaina F, Cordani C, Donzelli S, Lazzarini SG, Arienti C, Del Furia MJ, Negrini S. Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review. Children. 2022; 9(11):1672. https://doi.org/10.3390/children9111672

Chicago/Turabian Style

Zaina, Fabio, Claudio Cordani, Sabrina Donzelli, Stefano Giuseppe Lazzarini, Chiara Arienti, Matteo Johann Del Furia, and Stefano Negrini. 2022. "Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review" Children 9, no. 11: 1672. https://doi.org/10.3390/children9111672

APA Style

Zaina, F., Cordani, C., Donzelli, S., Lazzarini, S. G., Arienti, C., Del Furia, M. J., & Negrini, S. (2022). Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review. Children, 9(11), 1672. https://doi.org/10.3390/children9111672

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