Is brace treatment unnecessary for cases of adolescent idiopathic scoliosis above Risser sign 3?

Abstract

Skeletally mature cases of adolescent idiopathic scoliosis with mild curves are generally considered to have a low risk of deterioration. Previous reports have indicated that brace treatment in these cases has a high success rate; however, it is unclear whether brace treatment is necessary. The purpose of this study was to determine the incidence of adolescent idiopathic scoliosis progression during one year of follow-up in cases with a Risser sign ≥3, which were not treated with a brace, and to identify risk factors for progression. This retrospective, single center study included 54 cases of adolescent idiopathic scoliosis presenting to a university hospital in Japan between 2008 and 2017, with a Risser sign ≥3, which were not treated with brace treatment and had at least 2 years of follow-up data. The primary outcome was adolescent idiopathic scoliosis progression, defined as a deterioration in the Cobb angle of ≥ 6. Statistical analyses were performed to identify patient characteristics that were associated with progression. The mean age of the 54 included cases was 14.1 years, and the male to female ratio was 8:46. Scoliosis progressed in 8 (14.8%) cases within 2 years of follow-up. Female patients with progression were more likely to have recently gone through menarche than those without progression (p < 0.01). There was a slight statistical difference in age (p < 0.05), but no significant differences in sex, Risser-sign Stage, initial Cobb angle or main curve between adolescent patients with and without progression. We recommend brace treatment for cases of adolescent idiopathic scoliosis with a Risser sign ≥ 3 who have recently gone through menarche.