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Abstract from the SRS 2002 Annual Meeting
Introduction: A consecutive series of patients with adolescent
idiopathic scoliosis (AIS), treated between 1968 and 1977
before 21 years of age, with brace (BT, n=127; 122 females and
5 males) were followed at least twenty years after
completion of the treatment.
Purpose: To determine the long term outcome in terms of back pain
and function in patients brace treated for AIS.
METHODS: One hundred and nine patients were reexamined as part
of an unbiased personal follow-up, including a clinical
examination, evaluation of curve size (Cobb method) and degenerative
findings in full standing frontal and lateral radiographs,
validated questionnaires in terms of general and disease-specific
quality of life aspects as well as present back and pain
symptoms. An age- and sex-matched control group (CTR) of 100 persons
was randomly selected and subjected to the same
examinations.
Results: Curve size (major curve) was mean 38 degrees (SD 15,
5-71) with a mean increase of 8 degrees from end of
treatment to present follow-up. Significantly more patients complained
of back pain during the last year (77%) in comparison
to the control group (58%, p=0.0012). Pain was located significantly
more often in the lumbar (67% of BT vs 47% of CTR)
as well as the thoracic region (35% vs 22% repectively), but not
in the cervical region. 24% of the patients with pain
admitted daily pain but analgesics were sparsely used. A slight
but significant difference of the Oswestry Disability Questionnaire
as well as scores reflecting general back funtion was found between
the patients and controls. No differences could be
seen in sociodemographic variables between the groups, except
for having been on sick-leave ever due to the back (38% vs
19%, p=0.0036). No correlation could be found between pain and
its localization and curve size, increase at least 10° since
end of treatment, curve type, degenerative changes on any of the
two lowest lumbar disc levels, Body Mass index or smoking.
Discussion and Conclusion: Patients brace treated for adolescent
idiopathic scoliosis were found to have approximately the
same back function as the general population. A few were physically
severely disabled due to the back.
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