AUTHOR=Sha Lin , Zhang Tianyuan , Sui Wenyuan , Fan Qing , Yang Jingfan , Deng Yaolong , Huang Zifang , Yang Junlin TITLE=Comparison of the efficacy of thoracolumbosacral and lumbosacral orthosis for adolescent idiopathic scoliosis in patients with major thoracolumbar or lumbar curves: a prospective controlled study JOURNAL=Frontiers in Pediatrics VOLUME=12 YEAR=2024 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1368201 DOI=10.3389/fped.2024.1368201 ISSN=2296-2360 ABSTRACT=Introduction

Thoracolumbosacral orthosis (TLSO) is the most commonly used type of brace for the conservative treatment of adolescent idiopathic scoliosis (AIS). Although lumbosacral orthosis (LSO) is designed to correct single thoracolumbar or lumbar (TL/L) curves, its effectiveness remains underexplored. This novel article aims to compare the effectiveness of LSO with TLSO in treating AIS with main TL/L curves.

Methods

This prospective controlled cohort study enrolled patients with AIS with main TL/L curves and minor thoracic curves who were treated with either TLSO or LSO. Demographic and radiographic data were compared between the two groups. Treatment outcomes were also assessed. Risk factors for minor curve progression were identified, and a cut-off value was determined within the LSO group.

Results

Overall, 82 patients were recruited, including 44 in the TLSO group and 38 in the LSO group. The initial TL/L curves showed no difference between both groups. However, the baseline thoracic curves were significantly larger in the TLSO group compared to the LSO group (25.98° ± 7.47° vs. 18.71° ± 5.95°, P < 0.001). At the last follow-up, LSO demonstrated similar effectiveness to TLSO in treating TL/L curves but was less effective for thoracic curves. The initial magnitude of thoracic curves was identified as a risk factor for minor curve outcomes in the LSO group. The ROC curve analysis determined a cut-off value of 21° for thoracic curves to predict treatment outcomes.

Discussion

In contrast to TLSO, LSO exhibits comparable effectiveness in treating main TL/L curves, making it a viable clinical option; however, it is less effective for thoracic minor curves. The initial magnitude of the minor thoracic curves may guide the selection of the appropriate brace type for patients with AIS with main TL/L curves.