3rd International Conference On Conservative Management of Spinal Deformities

​Analyse de survie d'une cohorte consecutive de 365 patients scoliotiques tmites par le corset dynamique SpineCor a l'hopital Sainte Justine.

Abstract

Study Design. A prospective study was conducted on 365 patients with adolescent idiopathic scoliosis treated with the Dynamic SpineCor Brace.

Objectives. To evaluate the effectiveness of the Dynamic SpineCor Brace for the treatment of adolescent idiopathic scoliosis among those with milder and more severe curves.

Summary of Background Data. Prior to this study, we did an exhaustive literature review on traditional rigid braces available on the market such as Boston, \Wilmington, Milwaukee, Charleston and TLSO as well as the Dynamic SpineCor Brace (flexible and dynamic brace).

Methods. A group of 365 adolescents with idiopathic scoliosis were followed during the course of their treatment with the SpineCor Brace. The cohort of patients was divided into two groups according to their initial Cobb angle: 1) milder group: having a curve between 15° and 29° and 2) a more severe group: having a curve of 30° or more. A survival analysis was performed to estimate the cumulative probability of success during treatment and at post-treatment follow-up period. To be qualified as a success, the patient must have either a stabilization (± 5°) or a correction (more than 5°) of their initial Cobb angle. Failure was defined as a worsening of more than 5°.

Results. The survival analysis indicated a cumulative probability of success which is relatively stable for the patients in treatment with the SpineCor brace (Year 1: 1.00, 0.97;
Year 2: 0.96, 0.89;
Year 3: 0.85, 0.80; 
Year 4: 0.65, 0.70 for group 1 and 2 respectively) and which is maintained for the post-treatment follow-up period
(Year 1: 0.97, 0.88;
Year 2: 0.94, 0.88;
Year 3: 0.91, 0.84;
Year 4: 0.79, 0.84;
Year 5: 0.67, 0.84 for group 1 and 2 respectively). The conservative treatment was a success for 84.6% of the 120 patients who had 1 year post-bracing follow-up. Twenty-six patients were followed for 5 years after the end of the treatment by the Dynamic. SpineCor Brace. Of these, 65.4% obtained a permanent correction of their initial Cobb angle, 30.8% stabilized their Cobb angle and only 3.8% worsened without having recourse to the surgery.

Conclusion. The SpineCor Brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, the positive outcome appears to be maintained in the long turn.

Key words : Adolescent idiopathic scoliosis - Orthopaedic treatment - Dynamic SpineCor Brace

1. Centre de Recherche, Hospital Sainte Justine et Universite de Montreal, Canada.
2. Universite de Toronto, Toronto, Ontario
Auteur de correspondance: Charles H. Rivard, MD, F.R,C.S,(c), FAA.O.S., FA.C.S.
Centre de Recherche, Hospital Sainte Justine - 31 5Core Ste-Catherine - Montreal, Quebec Canada H3T1C5
Tel: 1-514-345-2344 - Fax: 1-514-345-4723
Email: Charles-hilaire.rivard@recherche-ste-justine.qe.ca

Resonances Europeennes du Rachis -Volume 14 N° 43 - 2006