ArticleJB & JS open access
Early Brace Treatment: The New Standard for Adolescent Idiopathic Scoliosis?
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: No direct comparison exists between early bracing of adolescent idiopathic scoliosis (AIS) at curve magnitudes of 15° to 24° vs. observation until the Scoliosis Research Society-recommended criteria of ≥25°. We compared curve improvement and progression between early bracing vs. standard treatment with bracing starting at ≥25°. Methods: A retrospective review was performed among patients Risser 0 to 1 with AIS curves 15° to 24° at initial visit who were followed until skeletal maturity or surgery. Patients prescribed rigid thoracolumbar sacral orthoses (TLSO) for curves 15° to 24° (early group) were compared with a control group observed until TLSO prescription at ≥25° (standard group). A subanalysis of open triradiate cartilage status (TRC) was performed. At final follow-up, patients were categorized into curve improvement ≥6°, stable (-5° to +5°), progression ≥6°, and progression to surgical magnitude (≥45°). Results: Among 414 patients (207 early, 207 standard) matched by skeletal maturity, the early group had greater curve improvement (19% vs. 1%, p < 0.001, odds ratio 16.3), greater stability (50% vs. 37%, p = 0.007), less progression ≥6° (31% vs. 62%, p < 0.001), and less progression to a surgical magnitude (6% vs. 14%, p = 0.014) than the standard group. Patients with open TRC highlighted these differences, with the early group demonstrating greater curve improvement (18% vs. 2%, p < 0.01), greater stability (42% vs. 21%, p < 0.001), less progression ≥6° (39% vs. 77%, p < 0.001), and less progression to a surgical magnitude (9% vs. 20%, p = 0.018) than the standard group, especially those with thoracic curves 20° to 24° at initial visit (13% vs. 43%, p = 0.001). The number needed to treat was 3.3. Conclusion: Early brace treatment of AIS curves 15° to 24° is superior to observation until brace initiation at 25°, with a 16-fold increased likelihood of improving curves and reducing progression to a surgical threshold by >50%. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.