POEMs

Impact of Bracing in Adolescents with Idiopathic Scoliosis



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Am Fam Physician. 2014 Mar 15;89(6):481.

Clinical Question

Does the use of bracing prevent the need for surgery in adolescents with idiopathic scoliosis who are at risk of curve progression?

Bottom Line

When compared with observation, bracing significantly slows progression of high-risk curves to the surgery threshold (Cobb angle greater than 50 degrees), with a number needed to treat (NNT) of 4 in the randomized portion of the trial. This benefit is greater with more daily hours of brace wear. (Level of Evidence = 1b)

Synopsis

The Bracing in Adolescent Idiopathic Scoliosis Trial (BRAIST) enrolled 242 affected adolescents; 116 were randomized to wear a brace or to observation, whereas 126 teens preferentially chose between the two options (the preference cohort was added because of low enrollment in the randomized trial). All patients were between 10 and 15 years of age, were previously untreated, and had a Cobb angle between 20 and 40 degrees and Risser skeletal

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.



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