Skip to main content
Top
Published in: European Spine Journal 6/2017

01-06-2017 | Original Article

Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study

Authors: Fabio Zaina, Sabrina Donzelli, Stefano Negrini

Published in: European Spine Journal | Issue 6/2017

Login to get access

Abstract

Purpose

Overweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AIS patients.

Methods

Design: retrospective cohort study. Population: 351 AIS patients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2. Inclusion criteria: no previous treatment, full-time prescription of brace at first visit (18–23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated. Outcome: improved, progressed, and stable according to the 5° Cobb agreed threshold. Statistics: a stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied.

Results

BMI is poorly correlated with final results. Confounders’ adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively.

Discussion

Brace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.
Appendix
Available only for authorised users
Literature
2.
go back to reference Coillard C, Circo AB, Rivard CH (2014) A prospective randomized controlled trial of the Natural History of Idiopathic Scoliosis versus treatment with the Spinecor brace. Sosort Award 2011 Winner. Eur J Phys Rehabil Med 50:479–487PubMed Coillard C, Circo AB, Rivard CH (2014) A prospective randomized controlled trial of the Natural History of Idiopathic Scoliosis versus treatment with the Spinecor brace. Sosort Award 2011 Winner. Eur J Phys Rehabil Med 50:479–487PubMed
5.
go back to reference Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Jt Surg Am 66:1061–1071CrossRef Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Jt Surg Am 66:1061–1071CrossRef
6.
go back to reference Peterson LE, Nachemson AL (1995) Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from The Brace Study of the Scoliosis Research Society. J Bone Jt Surg Am 77:823–827CrossRef Peterson LE, Nachemson AL (1995) Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from The Brace Study of the Scoliosis Research Society. J Bone Jt Surg Am 77:823–827CrossRef
7.
go back to reference Little DG, Song KM, Katz D, Herring JA (2000) Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls. J Bone Jt Surg Am 82:685–693CrossRef Little DG, Song KM, Katz D, Herring JA (2000) Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls. J Bone Jt Surg Am 82:685–693CrossRef
8.
go back to reference Yrjönen T, Ylikoski M, Schlenzka D et al (2006) Effectiveness of the Providence nighttime bracing in adolescent idiopathic scoliosis: a comparative study of 36 female patients. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 15:1139–1143. doi:10.1007/s00586-005-0049-9 CrossRef Yrjönen T, Ylikoski M, Schlenzka D et al (2006) Effectiveness of the Providence nighttime bracing in adolescent idiopathic scoliosis: a comparative study of 36 female patients. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 15:1139–1143. doi:10.​1007/​s00586-005-0049-9 CrossRef
9.
go back to reference Karol LA (2001) Effectiveness of bracing in male patients with idiopathic scoliosis. Spine 26:2001–2005CrossRefPubMed Karol LA (2001) Effectiveness of bracing in male patients with idiopathic scoliosis. Spine 26:2001–2005CrossRefPubMed
11.
go back to reference Smith FM, Latchford GJ, Hall RM, Dickson RA (2008) Do chronic medical conditions increase the risk of eating disorder? A cross-sectional investigation of eating pathology in adolescent females with scoliosis and diabetes. J Adolesc Health Off Publ Soc Adolesc Med 42:58–63. doi:10.1016/j.jadohealth.2007.08.008 CrossRef Smith FM, Latchford GJ, Hall RM, Dickson RA (2008) Do chronic medical conditions increase the risk of eating disorder? A cross-sectional investigation of eating pathology in adolescent females with scoliosis and diabetes. J Adolesc Health Off Publ Soc Adolesc Med 42:58–63. doi:10.​1016/​j.​jadohealth.​2007.​08.​008 CrossRef
14.
go back to reference O’Neill PJ, Karol LA, Shindle MK et al (2005) Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Jt Surg Am 87:1069–1074. doi:10.2106/JBJS.C.01707 CrossRef O’Neill PJ, Karol LA, Shindle MK et al (2005) Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Jt Surg Am 87:1069–1074. doi:10.​2106/​JBJS.​C.​01707 CrossRef
18.
go back to reference Stokes IA (2008) Stature and growth compensation for spinal curvature. Stud Health Technol Inform 140:48–51PubMed Stokes IA (2008) Stature and growth compensation for spinal curvature. Stud Health Technol Inform 140:48–51PubMed
19.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240CrossRefPubMedPubMedCentral
20.
go back to reference Zaina F, Atanasio S, Negrini S (2008) Clinical evaluation of scoliosis during growth: description and reliability. Stud Health Technol Inform 135:125–138PubMed Zaina F, Atanasio S, Negrini S (2008) Clinical evaluation of scoliosis during growth: description and reliability. Stud Health Technol Inform 135:125–138PubMed
23.
go back to reference Zaina F, De Mauroy JC, Grivas T et al (2014) Bracing for scoliosis in 2014: state of the art. Eur J Phys Rehabil Med 50:93–110PubMed Zaina F, De Mauroy JC, Grivas T et al (2014) Bracing for scoliosis in 2014: state of the art. Eur J Phys Rehabil Med 50:93–110PubMed
25.
go back to reference D’Amato CR, Griggs S, McCoy B (2001) Nighttime bracing with the Providence brace in adolescent girls with idiopathic scoliosis. Spine 26:2006–2012CrossRefPubMed D’Amato CR, Griggs S, McCoy B (2001) Nighttime bracing with the Providence brace in adolescent girls with idiopathic scoliosis. Spine 26:2006–2012CrossRefPubMed
26.
go back to reference Gepstein R, Leitner Y, Zohar E et al (2002) Effectiveness of the Charleston bending brace in the treatment of single-curve idiopathic scoliosis. J Pediatr Orthop 22:84–87PubMed Gepstein R, Leitner Y, Zohar E et al (2002) Effectiveness of the Charleston bending brace in the treatment of single-curve idiopathic scoliosis. J Pediatr Orthop 22:84–87PubMed
28.
go back to reference Howard A, Wright JG, Hedden D (1998) A comparative study of TLSO, Charleston, and Milwaukee braces for idiopathic scoliosis. Spine 23:2404–2411CrossRefPubMed Howard A, Wright JG, Hedden D (1998) A comparative study of TLSO, Charleston, and Milwaukee braces for idiopathic scoliosis. Spine 23:2404–2411CrossRefPubMed
29.
go back to reference Katz DE, Richards BS, Browne RH, Herring JA (1997) A comparison between the Boston brace and the Charleston bending brace in adolescent idiopathic scoliosis. Spine 22:1302–1312CrossRefPubMed Katz DE, Richards BS, Browne RH, Herring JA (1997) A comparison between the Boston brace and the Charleston bending brace in adolescent idiopathic scoliosis. Spine 22:1302–1312CrossRefPubMed
34.
go back to reference Sun W, Zhou J, Sun M et al (2016) Low body mass index can be predictive of bracing failure in patients with adolescent idiopathic scoliosis: a retrospective study. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. doi:10.1007/s00586-016-4839-z Sun W, Zhou J, Sun M et al (2016) Low body mass index can be predictive of bracing failure in patients with adolescent idiopathic scoliosis: a retrospective study. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. doi:10.​1007/​s00586-016-4839-z
35.
go back to reference Bitan FD, Veliskakis KP, Campbell BC (2005) Differences in the Risser grading systems in the United States and France. Clin Orthop 436:190–195CrossRef Bitan FD, Veliskakis KP, Campbell BC (2005) Differences in the Risser grading systems in the United States and France. Clin Orthop 436:190–195CrossRef
Metadata
Title
Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study
Authors
Fabio Zaina
Sabrina Donzelli
Stefano Negrini
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 6/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-4985-y

Other articles of this Issue 6/2017

European Spine Journal 6/2017 Go to the issue