Influence of Bracing and Elastic Belt on Sagittal Profile in Adolescent Idiopathic Scoliosis
Abstract
Introduction: Bracing is the most commonly used non-operative treatment for adolescent idiopathic scoliosis (AIS). However, it may lead to thoracic kyphosis (TK) reduction. The elastic belt (EB) has been used as brace in some AIS patients. The effect of EB on sagittal profile has not been reported.
Objective: To evaluate the effect of brace and EB on the sagittal profile of AIS patients.
Method: 21 patients treated with Milwaukee brace and 16 patients with Boston brace were included. Standing lateral X-ray films were obtained in three conditions: without treatment, with brace and with EB. The following parameters were measured: (1) T5-T12 TK, (2)T2-T12 TK, (3) L1-S1 lumber lordosis (LL), (4) sacral slope, (5) pelvic tilt, (6) pelvic incidence. All parameters were analyzed using paired-t test between 3 conditions.
Results: The T5-T12 TK and T2-T12 TK were significantly different between 3 conditions. The TK was reduced by brace and more by EB. In Milwaukee brace subjects, L1-S1 lordosis was similar when wear EB or no treatment but significantly smaller when wear brace. No significant differences were found in pelvic parameters between the 3 conditions in both groups.
Conclusion: The TK and LL were reduced by brace .The EB show more reduction effect on the TK but no effect on LL.
Significance: Thoracic hypokyphosis has been thought as a risk factor of curve progression and harm to pulmonary function in AIS patients. Significant reduction effect on thoracic kyphosis should be considered when using EB as brace for AIS.