Effectiveness of Orthopedic Bracing in the Management of Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial

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Abstract

Background: Scoliosis is a complex spinal condition that often requires bracing as a significant treatment to prevent spinal deterioration in adolescent idiopathic scoliosis (AIS). Adaptation can be difficult; the effectiveness of support is well documented and treatment aims to improve the spine and body's quality of life. Objective: The objective of the study is to evaluate the effectiveness of bracing as a treatment for preventing spinal deterioration in adolescent idiopathic scoliosis (AIS) and to assess its impact on the quality of life and spinal health of patients. Study Design: This one-arm quasi-experimental study. Settings: Outpatient department of tertiary care hospitals of Sindh i-e Civil Hospital, Suleman Roshan and Memon Charitable Hospital, Pakistan. Duration: One year from 15-04-2023 to 15-04-2024. Methods: The study evaluated the effectiveness of bracing in 20 AIS patients aged 10-17 with Cobb angles of 20°-40°, excluding those with prior treatments or other pathologies. Patients received thoracolumbosacral orthoses (TLSO) and were monitored regularly, required to wear braces 23 hours daily. Assessments of trunk inclination, Cobb angle, and body image were conducted every six months over a year, with radiographic and shoulder balance evaluations performed and bisphosphonates were advised during visits. Results: The study involved 20 AIS patients (11 females, 9 males) with a mean age of 13.8 years and an average baseline Cobb angle of 27.6 degrees. Over 12 months, the mean Cobb angle significantly decreased to 23.12 degrees, indicating a meaningful reduction in spinal curvature. Notable improvements were observed from baseline to 6 months (mean reduction of 2.23 degrees, P < 0.001) and from 6 months to 12 months (mean reduction of 2.89 degrees, P < 0.001), demonstrating significant and clinically meaningful corrections in spinal alignment. Conclusion: The findings highlight the effectiveness of bracing in reducing spinal curvature in adolescents with scoliosis, suggesting promising interventional strategies to improve patient outcomes.