European Vertebral  Deviations Center - Clinique du Parc - Lyon (France)    Final Results

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Final Results

CORRELATION BETWEEN FINAL RESULT AND FIRST X-RAY WITHOUT BRACE 6 MONTHS AFTER FITTING ARTBRACE: CASE SERIES OF THE 33 FIRST CONSECUTIVE PATIENTS.

Authors and Institutions: De Mauroy JC, Gagliano F, Barral F, Pourret S.

Introduction: The very high rigidity of the polycarbonate makes it possible to replace the plaster cast. The ARTbrace is designed from a digital cast made by superimposing the frontal and sagittal corrections of 3 blocks: pelvis, lumbar and thoracic. This unique feature ensures an average in-brace correction of 70% during treatment. The ability to predict the final result is an element of compliance and sometimes of earlier orientation towards surgery.
Objective(s): The aim is to determine the correlation coefficient between the correction at 6 months and the final correction 2 years after weaning the ARTbrace.
Method(s): Of the first 300 patients treated in Lyon since May 2013, 33 (29 females/4males) were reviewed 2 years after brace weaning (from September 2016 to September 2017). From our prospective database, the Cobb angle of 45 primitive curves (22 thoracic and 23 lumbar) was studied: initial, in-brace, at 6 months, at the end of treatment, 6 months and 2 years after brace weaning.
The paired sample correlation T-test and non-parametric Spearman and Pearson was performed using the SPSS v20 package for Cobb angle at 6 months and 2 years after weaning.
Result(s) and Discussions: The 33 patients had an initial mean age of 14.2 (SD=1.35).
The initial mean angulation is: 27.3° (SD = 6.51)
The average in-brace angulation is: 8.27 (SD = 8.32)
The average angulation at 6 months without brace is: 16.52 (SD=9.36)
The average angulation two years after weaning is: 18.31° (SD=9.03)
The average In-brace correction percentage is 70%, the definitive average correction 2 years after brace weaning is 32.6%.
The progression of curve magnitude is presented in figure 1.


A paired-sample t-test was conducted to compare Cobb angulation at 6 months and Cobb angulation 2 years after brace weaning. For thoracic curves, there was no significant difference in the scores at 6 months (M=19.65, SD=9.016) and final (M=20.14, SD=8.919). For lumbar curves, there was no significant difference in the scores at 6 months (M=17.17, SD=9.079) and final (M=16.57, SD=8.974).
A Pearson product-moment correlation coefficient was computed to assess the relationship between Cobb angulation at 6 months and Cobb angulation 2 years after brace weaning There was a strong positive correlation between the two variables, r = .897, n = 22, p<0.001 for thoracic curves and r=.870, n=23 p<0.001 for lumbar curves.
A Spearman's rank-order correlation was run to determine the relationship between Cobb angulation at 6 months and Cobb angulation 2 years after brace weaning. There was a strong, positive correlation, which was statistically significant for thoracic curves (rs(22) = .885, p <0.01) and for lumbar curves (rs(23) = .883, p <0.01)


The initial mean angulation is lower than the 30° initial general average of the prospective study because it does not yet include the most important curvatures with a longer treatment time.
Conclusion(s) and Significance: The average in-brace correction of 70% has not changed since the beginning of the prospective study.
The final correction of more than 30% is the equivalent of most in-brace corrections published to date.
The correlation between angulation at 6 months and the final outcome is close to 0.9, which makes it possible to predict the final result very early and answers a question often asked by parents. Then the final result depends only on compliance.
 

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