The effect of brace on apical vertebral derotation in adolescent idiopathic scoliosis

PurposeThe current study aims to evaluate the effect of Boston brace treatment on apical vertebral derotation in adolescent idiopathic scoliosis (AIS) patients receiving conservative treatment.MethodsThe study included 51 AIS patients, consisting of 8 males and 43 females, with Cobb angles between 25 degrees and 45 degrees and Risser's findings ranging from 0 to 4. The mean age of the participants was 12.20 +/- 1.34 years. All patients were treated with the Boston brace for a minimum of 2 years and evaluated before the brace, during early brace use, and at the last follow-up. Radiographs were assessed to measure apical vertebral rotation (AVR) and vertebral translation (AVT). The SRS-22 questionnaire was used to evaluate patient outcomes.ResultsThe radiographs of patients were evaluated over a mean follow-up period of 32.42 +/- 8.65 months. Before the brace, the mean AVR was 2.1 +/- 0.6, while it was 1.1 +/- 0.5 with the brace. At the last follow-up, the mean AVR was 1.3 +/- 0.5 (p < 0.001). Before the brace, the mean AVT was 36.4 +/- 9.6 mm, which decreased to 16.7 +/- 7.3 mm with the brace (p < 0.001). At the last follow-up, the mean AVT was 19.8 +/- 8.1 mm (p < 0.001). The use of the brace had a significant corrective effect on thoracolumbar and lumbar curvatures compared to before the brace (p < 0.001).ConclusionThe findings of the current study suggest that the use of a Boston brace in the conservative treatment of AIS is effective in correcting the coronal and sagittal plane deformities, including thoracic, thoracolumbar, and lumbar curvatures, and in reducing apical vertebral rotation and translation.