Efficacy Analysis For Adolescent Idiopathic Scoliosis Treated With Milwaukee Or Boston Orthosis

Objective:To evaluate the efficacy about the different wearing manner with Milwaukee and Boston for the treatment of adolescent idiopathic scoliosis(AIS).Methods:Retrospectively summarized and analyzed 85 adolescent patients with idiopathic scoliosis who were treated during February 2004 -March 2009.The skeletal growth of them had not completed.There were 57 cases who received brace treatment.In them,28 were treated with (CTLSO)-Milwaukee brace,and the rest were treated with(TLSO) -Boston brace and Orthopedic gymnastics.The 30 cases could follow doctor's orders to wear regularly for 21 to 23 hours every day,and the 27 cases could consist on wearing only 6 to 15 hours every day.For some reasons,the other 28 cases of 85 AIS cases only treated with Orthopedic gymnastics instead of orthosis treatment.To observe periodically all of the patients by lateral side X-ray photograph at standing position and photograph,and to measure Cobb angle and Risser sign each 3 to 6 months.Since 2008 all adolescent idiopathic scoliosis patients treated with orthosis were requested to fill with simplified Chinese SRS-22.Results:73 cases adolescent idiopathic scoliosis patients were followed up for 2-5 years(mean 26.3 months).①Milwaukee orthosis group:the regular wearing group with 91.67%effective rate;the intermittent wearing group with 56.25%effective rate;the group without wearing orthosis with 20%effective rate.By compared groups each other found:the group wearing regularly Milwaukee brace is superior to the other two groups(P＜0.05).Boston orthosis group:the regular wearing group with 88.89%effective rate,the intermittent wearing group with 54.55%effective rate,the group without wearing brace with 25% effective rate.By compared groups each other,found:the group wearing regularly Boston brace is superior to the other two groups(P＜0.05).Due to the different choice of AIS patients and orthosis,so the rearch don't to compared the effective rate of the Milwaukee and Boston orthosis.②The AIS patients with RisserⅠdegree compared with the AIS patients with RisserⅡorⅢdegree,the Cobb angle correction rate are statistically very different(P＜0.05);③The AIS patients with the single thoracic curve compared with the AIS patients with the mainly double thoracolumbar curve and the single thoracolumbar or lumbar curve,the Cobb angle correction rate are statistically very different(P＜0.05);Conclusions:①The adolescent idiopathic scoliosis patients should insist on wearing regularly brace regardless of the Milwaukee or Boston orthosis(this article suggest that the wearing time should not less than 21-23h/d).The group wearing regularly with the Milwaukee or Boston orthosis is superior to the intermittent group or the group without wearing brace by X~2 test.It's curative for the AIS patients who accord with the indication of orthosis treatment.②The degree of Risser sign angle is smaller,the efficacy of rectification is better,because the flexibility of body is better.③The AIS patients with the single thoracic scoliosis has the better correction rate with brace and Orthopedic gymnastics by compared with the AIS patients with the mainly double thoracolumbar curve and the single thoracolumbar or lumbar curve.