Predictors of Clinically Meaningful Results of Bracing in a Large Cohort of Adolescents with Idiopathic Scoliosis Reaching the End of Conservative Treatment

Background: We need good outcome predictors to maximize the treatment efficiency of adolescents with idiopathic scoliosis (AIS). The in-brace correction has shown an important predictive effect on brace failure, while the influence of other variables is still debated. We aimed to identify new outcome predictors from a big prospective database of AIS. Methods: Design: Retrospective analysis of prospectively collected data. Inclusion criteria: AIS between 21 and 45 degrees, Risser 0-2, brace prescription during the observation, treatment conclusion. All of the participants followed a personalized conservative approach according to the SOSORT Guidelines. Outcomes: End of growth below 30 degrees-40 degrees-50 degrees. The regression model included age, BMI, Cobb angle, ATR, TRACE score, real brace wear (RBW), and in-brace correction (IBC). Results: A total of 1050 patients, 84% females, ages 12.1 +/- 1.1, 28.2 +/- 7.9 degrees Cobb. IBC increased by 30%, 24%, and 23% the odds of ending treatment below 30 degrees, 40 degrees, and 50 degrees, respectively. The OR did not change after the covariate adjustment. Cobb angle and ATR at the start also showed a predictive effect. Conclusions: The systematic evaluation of IBC in clinics is useful for individuating the patient response to brace treatment more accurately, even in relation to the Cobb angle and ATR degrees at the start. Further studies are needed to increase the knowledge on predictors of AIS treatment results.