大阪医科大学(OMC)支架治疗青少年特发性脊柱侧凸的疗效遵循脊柱侧凸研究会支架研究标准。

Scoliosis Pub Date : 2015-04-11 eCollection Date: 2015-01-01 DOI:10.1186/s13013-015-0036-9
Hiroshi Kuroki, Naoki Inomata, Hideaki Hamanaka, Kiyoshi Higa, Etsuo Chosa, Naoya Tajima
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引用次数: 16

摘要

背景:支架治疗青少年特发性脊柱侧凸(AIS)的疗效仍有争议。为了使研究之间的比较更加有效和可靠,脊柱侧凸研究协会(SRS)为AIS患者的支架研究制定了标准化的标准。本研究的目的是根据SRS委员会提出的关于支具和非手术管理的修订标准化标准,评估大阪医科大学(OMC)支具治疗AIS的疗效。方法:从1999年到2010年,连续研究31例新开OMC支具并符合修改SRS标准的AIS患者。该研究包括2名男孩和29名女孩,平均年龄12岁零个月。指导患者在支架治疗开始时每天佩戴支架至少20小时。支具治疗的平均时间为4年8个月。我们观察了所有病例的初始支具矫正率和主要弯曲的临床结果,以弯曲进展和手术率评估,并以指导依从率评估依从性。根据SRS判断标准,如果发生≥6°曲率增加,则认为支架治疗的临床过程是进展,如果发生≥6°曲率减少,则认为支架治疗的临床过程是改善。结果:支具初次矫正率平均为46.8%。曲线进展10例,曲线改善6例,曲线不变15例(成功率67.7%)。平均指导依从率,即患者声称他们大部分遵循我们的指导的就诊次数占总就诊次数的百分比,为53.7%。遵教率大于50%的患者组(88.2%)的成功率高于遵教率小于50%的患者组(42.8%)。结论:OMC支架治疗可以改变AIS患者的自然病史,并显著降低弯曲的进展至手术干预的阈值。良好的指导依从性与更大的成功相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria.

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria.

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria.

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria.

Background: The efficacy of brace treatment for patients with adolescent idiopathic scoliosis (AIS) remains controversial. To make comparisons among studies more valid and reliable, the Scoliosis Research Society (SRS) has standardized criteria for brace studies in patients with AIS. The purpose of this study was to evaluate the efficacy of the Osaka Medical College (OMC) brace for AIS in accordance with the modified standardized criteria proposed by the SRS committee on bracing and non-operative management.

Methods: From 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. Patients were instructed to wear the brace for a minimum of 20 hours per day at the beginning of brace treatment. The mean duration of brace treatment was 4 years and 8 months. We examined the initial brace correction rate and the clinical outcomes of main curves evaluated by curve progression and surgical rate, and the compliance evaluated by the instruction adherence rate for all cases. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria.

Results: The average initial brace correction rate was 46.8%. In 10 cases the curve progressed, 6 cases the curve improved, and 15 cases the curve remained unchanged (success rate: 67.7%). The mean instruction adherence rate, that was defined the percentage of the visits that patients declared they mostly followed our instruction to total visits, was 53.7%. The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% (88.2%) as compared with in those 50% or less (42.8%).

Conclusions: OMC brace treatment for AIS patients could alter the natural history and significantly decreased the progression of curves to the threshold for surgical intervention. Better instruction adherence of brace wear associated with greater success.

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