Intensive bracing management combined with physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis patients with a major curve ranging from 40-60° who refused surgery: a prospective cohort study.
Tianyuan Zhang, Zifang Huang, Wenyuan Sui and 5 others
PMID 36700244WHAT IT FOUND
Adolescents with 40-60° scoliosis curves who refused surgery achieved success in 78% of cases using intensive bracing and exercises.
Patients with curves under 50° had a 95% success rate, while those with larger curves had only 60% success.
Key findings
01Treatment success was achieved in 78% of patients in the intention-to-treat analysis, defined as keeping the main curve below 50° at skeletal maturity.
02Patients with baseline curves between 40-49° had a nearly 95% success rate, whereas those with curves between 50-60° had only a 60% success rate.
03A larger baseline curve magnitude, lower Risser stage, and lower in-brace correction rate were significantly associated with treatment failure.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study lacked a control group, so it is impossible to determine how many patients would have progressed without treatment. Bracing compliance was measured by patient recall and parental confirmation rather than objective sensors, which may introduce bias. The bracing protocol was empirical, with no standardized data-driven benchmarks for increasing corrective force, making it difficult to replicate exactly. The predictive model developed was complex and theoretical, limiting its practical use in clinical settings.
The easy way to misread this
Do not assume this treatment works equally well for all large curves. Success rates were 95% for curves under 50° but dropped to 60% for curves between 50-60°, meaning nearly half of patients with the largest curves still failed to avoid surgery.