Noting that serial casting is preferred for initial treatment of early onset scoliosis (EOS) but comes with concerns about complications and caregiver burden, researchers set out to determine if health-related quality of life (HRQoL) improved with a transition from serial casting to bracing. They concluded that patients experienced declines in HRQoL after casting, but assessment scores recovered to pretreatment baseline levels and were maintained at follow-up with a transition to bracing. They advise, however, that clinicians must still balance the effectiveness of EOS treatment for each patient.
Subjects with idiopathic EOS were retrospectively identified from a multicenter database, and 24-Item Early Onset Scoliosis Questionnaire (EOSQ) scores were compared before treatment, after index casting, after transition out of cast to brace, and at the most recent follow-up.
Sixty-six subjects met the inclusion criteria. Thirty-seven (56 percent) subjects were male and the average age at the time of index treatment was 1.9 (0.37-6.4) years. The average follow-up was 3.2 (0.90-6.8) years. In 57 subjects, the major curve magnitude improved from a mean of 33 degrees before treatment initiation to 27 degrees after casting and to 24 degrees at the most recent follow-up.
The researchers found a significant decrease in HRQoL during casting treatment and a recovery in scores during treatment. The pre-index treatment score was 84.9; 75.7 during casting treatment; 84.8 during brace treatment; and at 87 at the most recent follow-up.
The parental impact subdomain improved from the beginning to the end of treatment (77.7 to 87.7). Satisfaction improved from casting to bracing (73.4 to 86.7,) (n=63) and to the most recent follow-up (73.4 to 87.9).
The study, “Does Transitioning to a Brace Improve HRQoL After Casting for Early Onset Scoliosis?,” was published in the Journal of Pediatric Orthopaedics.
