Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB): assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

Background: The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect. The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB) in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management Standardisation Criteria. Methods: Fifty adolescent females (mean age 11.8 +/- 0.5 years) with thoraco-lumbar curve and a pretreatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 44.5 months). Antero-posterior radiographs were used to estimate the curve magnitude (CM) and the torsion of the apical vertebra (T-A) at 5 time points: beginning of treatment (t(1)), one year after the beginning of treatment (t(2)), intermediate time between t(1) and t(4) (t(3)), end of weaning (t(4)), 2-year minimum follow-up from t(4) (t(5)). Three situations were distinguished: curve correction, curve stabilisation and curve progression. The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests. Results: CM mean value was 29,30 +/- 5,16 SD at t(1) and 14,67 +/- 7,65 SD at t(5). T-A was 12.70 +/- 6,14 SD at t(1) and 8,95 +/- 5,82 at t(5). The variation between measures of Cobb and Perdriolle degrees at t(1,2,3,4,5) and between C-M t(5)-t(1) and T-A t(5)-t(1) were significantly different. Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients. Conclusion: The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.