Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

NIH study establishes benefits of bracing in adolescents with idiopathic scoliosis

20.09.2013
Bracing in adolescents with idiopathic scoliosis reduces the likelihood that the condition will progress to the point that surgery is needed, according to a study published online today in the New England Journal of Medicine. The work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health.

Adolescent idiopathic scoliosis (AIS) is a curvature of the spine with no clear underlying cause. In mild cases, monitoring over time by a physician may be all that is needed. However, in more severe cases — especially when the child is still growing — the use of a brace, or even surgery, may be recommended. Left untreated, more serious curves can cause pain and disability.


Before and after bracing x-rays of a girl with adolescent idiopathic scoliosis.

“While bracing has been a mainstay of non-operative treatment for AIS for decades, evidence regarding its impact has been inconclusive,” said NIAMS Director Stephen I. Katz, M.D., Ph.D. “This study is certain to enhance clinical decision-making regarding the non-operative management of AIS.”

Researchers from the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) set out to compare the risk of curve progression in adolescents with AIS who wore a brace with those who did not. The study team, led by Stuart Weinstein, M.D., and Lori Dolan, Ph.D., of the University of Iowa, Iowa City, recruited patients who — based on their age, skeletal immaturity and curve severity — were at high risk for continued worsening of their spinal curves.

Investigators enrolled 383 subjects at 25 institutions in the United States and Canada between March 2007 and February 2011. Although the study began as a completely randomized study, the team eventually added a preference cohort, where patients and families could choose their own treatment. Treatment was randomly assigned for about 40 percent of study participants and based on preference for the remainder.

Patients in the observation arm received no specific treatment, while those in the bracing arm were instructed to wear a brace for 18 hours per day. Treatment was considered to be unsuccessful when a curve progressed to 50 degrees or greater – a point at which surgery is typically recommended. Treatment was considered a success when the child reached skeletal maturity without this degree of curve progression.

In January 2013, the trial was stopped early after finding that bracing significantly reduced the risk of curve progression and the need for surgery, and that more hours of brace wear was associated with higher success rates. In the combined randomized and preference cohorts, 72 percent in the bracing group achieved success. Wearing a brace more than an average of 13 hours per day was associated with success rates of 90 to 93 percent. Of note is the fact that 48 percent of patients in the observation group, and 41 percent of patients in the bracing group who wore the brace infrequently, also had positive outcomes.

“This study presents important evidence addressing the fundamental question facing families and clinicians dealing with the diagnosis of AIS – to brace or not to brace,” said Weinstein. “Now we can say with confidence that bracing prevents the need for surgery.”

For more information on scoliosis in children and adolescents, visit http://www.niams.nih.gov/health_info/scoliosis.

The study was supported by the NIAMS/NIH under Award Numbers R21AR049587 and R01AR052113. Additional support was provided by the Shriners Hospitals for Children, the Canadian Institutes of Health Research, the University of Rochester, the Children’s Mercy Hospital and Clinics, and the Children’s Miracle Network.

The http://www.clinicaltrials.gov identifier for the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) is NCT00448448.

The mission of the NIAMS, a part of the U.S. Department of Health and Human Services' National Institutes of Health, is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about the NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS website at http://www.niams.nih.gov.


About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH...Turning Discovery Into Health®

Trish Reynolds | EurekAlert!
Further information:
http://www.nih.gov

Further reports about: AIS Cancer treatment Human vaccine NIAMS NIH health services idiopathic medical research scoliosis

More articles from Studies and Analyses:

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

nachricht Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

A big nano boost for solar cells

18.01.2017 | Power and Electrical Engineering

Glass's off-kilter harmonies

18.01.2017 | Materials Sciences

Toward a 'smart' patch that automatically delivers insulin when needed

18.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>