The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis
The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis
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DOI：
10.1097/bpo.0000000000001420
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发表时间：
2020-03-01
影响因子：
1.7
通讯作者：
Jo, ChanHee
中科院分区：
文献类型：
--
作者：
Karol, Lori A.;Wingfield, Jessica J.;Jo, ChanHee
背景：虽然已经发表的研究表明肥胖患者对支架使用的依从性较低，但没有客观的研究测量每天佩戴支架的时间，以将支架佩戴和成功与体重指数（BMI）联系起来。本研究的目的是建立BMI与支具依从性之间的关系，以及BMI与手术幅度达到50度或更高之间的关系。方法：175例青少年采用胸腰骶矫形器治疗1例青少年特发性脊柱侧凸，随访至治疗结束。按支具处方测量BMI，分为体重过轻（< 5百分位）、正常（< 5百分位，85%,95%）。热时计传感器用于测量顺应性。在支架处方、支架停用或手术时测量x线片。结果：体重过轻组比其他组戴牙套时间更长（BMI指数低15.7小时，正常12.5小时，高11.7小时，肥胖9.0小时）（BMI指数低对正常P=0.031，低对高P=0.01，低对肥胖P=0.01）。体重过轻组的手术进展率最高（60%），而正常BMI青少年的手术进展率为27.7%，超重患者为28.6%，肥胖患者为55.6%。BMI低组手术成功率明显高于BMI正常组（P=0.01）。结论：虽然超重和肥胖患者每天佩戴矫形器的时间最少，但体重不足的青少年手术风险最高，尽管依从性良好。
Background: Although studies have been published stating obese patients are less compliant with brace use, no objective studies measuring hours of daily brace wear have been performed to correlate brace wear and success with body mass index (BMI). The purpose of this study was to establish the relationship between BMI and brace compliance, and between BMI and progression to surgical magnitude of 50 degrees or more. Methods: A total of 175 adolescents were prescribed thoracolumbarsacral orthosis for the treatment of an adolescent idiopathic scoliosis and followed to completion of treatment. BMI was measured at brace prescription, and divided into: (1) underweight (< 5th percentile), (2) normal (>5th, 85%, 95%). Thermochron sensors were used to measure compliance. Radiographs were measured at brace prescription, and at time of brace discontinuation or surgery. Outcome was classified as successful if curve magnitude was Results: The underweight group wore their braces more hours than the other groups (15.7 h low, 12.5 h normal, 11.7 h high, and 9.0 h obese BMI (low vs. normal P=0.031, low vs. high P=0.01, low vs. obese P=0.01). The underweight group had the highest rate of surgical progression (60%), compared with 27.7% of normal BMI teens, 28.6% of overweight patients, and 55.6% of obese patients. The low BMI had a significantly higher rate of surgery than the normal BMI group (P=0.01). Conclusions: Although overweight and obese patients wear orthoses the least hours daily, the highest surgical risk is in underweight adolescents despite good compliance.