Long-term results after Boston brace treatment in adolescent idiopathic scoliosis

BACKGROUND: Few studies have evaluated long-term outcome after bracing using validated health related quality of life outcome measures. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS) 12 years or more after treatment with the Boston brace. METHODS: 109 (80%) of 135 patients (7 men) with AIS treated with the Boston brace at a mean of 19.2 (range 12-28) years previously responded to long-term follow-up examination.All patients (n = 109) answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI) (100-worst possible), General Function Score (GFS) (100 - worst possible), EuroQol (EQ-5D) (1 - best possible), EQ-VAS (100 - best possible)) and Scoliosis Research Society -22 (SRS - 22) (5 - best possible). Clinical and radiological examination was obtained in 86 patients. RESULTS: The magnitude of the primary prebrace major curve was in average 33.4 degrees (range 20 - 52). At weaning and at the last follow-up the corresponding values were 28.3 degrees (9-56) and 34.2 degrees (8 - 87), respectively. The mean age at follow-up was 35 (27 - 46) years. Work status was: full time (80%), on sick-leave (3%), on rehabilitation (4%), disability pension (4%), homemaker (7%), students (2%), 7% had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81%. The mean (standard deviation) ODI was 6.4 (9.8), GFS 5.4 (10.5), EQ-5D 0.84 (0.2), SRS-22: pain 4.2 (0.8), mental health 4.2 (0.7), self-image 3.9 (0.7), function 4.1 (0.6), satisfaction with treatment 3.7 (1.0). 28% had taken physiotherapy for back pain the last year and 12% had visited a doctor. CONCLUSION: Long-term results were satisfactory in most patients with AIS treated with the Boston brace.