Supplementary Addendum to “Radiation dose of digital radiography (DR) versus micro-dose x-ray (EOS) on patients with adolescent idiopathic scoliosis: 2016 SOSORT- IRSSD “John Sevastic Award” Winner in Imaging Research”

Skoliosis adalah kelengkungan tulang belakang ke lateral yang melebihi 10 derajat. Tinjauan lapangan pada klinik dan rumah sakit di Indonesia menunjukan banyaknya kasus pasien Adolescent Idiopathic Scoliosis (AIS) yang telah ditangani dengan penggunaan skoliosis brace. In-brace correction (IBR) merupakan cara menilai kualitas skoliosis brace secara cepat setelah brace dipasangkan kepada pasien dengan metode X-Ray dengan menggunakan brace. Akan tetapi, hasil IBR tersebut sering ditemukan berbeda dari satu pasien dengan yang lainnya sehingga dibutuhkan untuk mengetahui faktor yang dapat menyebabkan perbedaan tersebut. Oleh karena itu, tujuan pada penelitian ini adalah untuk menilai apakah terdapat hubungan antara tipe kurva dan besaran kurva terhadap IBR pada pasien AIS. Analisis retrospective sebanyak 120 data sekunder telah digunakan dalam penelitian ini melalui rekam medis pasien yang menggunakan scoliosis brace dari tahun 2016 - 2018. Data yang diambil berupa Cobb angle tanpa menggunakan brace, In-Brace Cobb angle, dan tipe kurva skoliosis. Rata-rata IBR adalah 56,0% pada besaran kurva ringan (20°-29°), 37,2% pada besaran kurva sedang (30° - 40°), 36,7% pada besaran kurva parah (>40°). Sedangkan, rata-rata IBR tertinggi adalah pada tipe kurva ganda dimana lumbar > thoraks yaitu sebesar 50,3%, lalu disusul dengan kurva tunggal thoraks dan kurva ganda thoraks > lumbar sebesar 40,3% dan 39,1% secara berurutan. terdapat perbedaan yang signifikan IBR bedasarkan Besaran Kurva dan Tipe Kurva pada pasien adolescent idiopatik skoliosis dengan p value 0,000 dan 0,029 secara berurutan. Dapat disimpulkan bahwa tipe dan besaran kurva scoliosis merupakan faktor yang dapat mempengaruhi hasil IBR secara signifikan

Download Full-text

Lack of In-Brace X-Rays in Compliant AIS Patients Wearing Full-Time TLSO Braces Associates with Failure

10.21203/rs.3.rs-447157/v1 ◽

2021 ◽

Author(s):

Isabel Alvarez ◽

Kiley Poppino ◽

Lori Karol ◽

Amy L McIntosh

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Successful Treatment ◽

Univariate Analysis ◽

Full Time ◽

X Rays ◽

Skeletally Immature ◽

X Ray ◽

Total Treatment ◽

Registration Date

Abstract BackgroundIn-brace correction and brace compliance with Thoraco-Lumbo-Sacral Orthotic (TLSO) braces are associated with successful treatment of Adolescent Idiopathic Scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not.MethodsAll skeletally immature (Risser 0–2) patients were treated for AIS (25°-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 hours a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation.Results90 patients (F:82, M:8) with an average age of 12.1(10.1–15.0) years, Risser grade 0(0–2), BMI percentile 48.5(0.0-98.8), and daily brace wear of 16.5(12.1–21.6) hrs/day were treated for 24.3(8.0-66.6) months. Patients went through 1.7(1–4) braces on average. 42/90(46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5–100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014).ConclusionsPatients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1(95% CI 1.2–7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays.Trial Registration:ClinicalTrials.gov - NCT02412137, Initial Registration Date April 2015

Download Full-text