Bracing in adult with scoliosis: Experience in diagnosis and classification from a 15 year prospective study of 739 patients

Abstract

Background: Despite the frequency of adult scoliosis, very few publications concern the conservative orthopaedic treatments. The indications have not been defined to date. The experience of a department specialized in rigid bracing allows us to consolidate and clarify diagnosis and indications as well. Methods: Individual observational prospective cohort study from a database started in 1998, with selection of all 739 adult scoliosis patients for which conservative orthopaedic treatment has been proposed to, even in case of drop-out. Scoliosis treated during adolescence and monitored in adulthood are included if a new brace is prescribed. A first descriptive study of the main parameters was performed: gender, age, Cobb angle. A tentative classification according to aetiology, age and angulation is proposed. Results:1) Descriptive Data: The Ratio Female/Male is 88 %, the mean age: 56.97 ± 15.82, the mean Cobb angle: 35.58 ± 17.35. The rate of non-adherent patients not wearing the brace is 17 % (but the plaster cast before bracing was routinely proposed at the time). Conclusions: The wide variety of adult scoliosis makes any objective classification difficult. This first approach is intended to specify the best indications of bracing in adulthood. 1. The female ratio is slightly higher than that of the adolescent.