Study: Adolescent Scoliosis Patients Do Better if Counseled

In yet another indication that good doctor-patient relationships are vital, a new study has found that to be especially important when it comes to adolescent scoliosis. “Patients who were aware that their device measured brace use, wore their brace, on average, an additional three hours each day, ” said orthopedic surgeon and lead study author Lori Karol, M.D., in the January 8, 2016 news release. This research, which appears in the Journal of Bone and Joint Surgery, also found that patients who wore their brace were less likely to require surgery, by 11%, due to less spinal progression.

In the study, led by Texas Scottish Rite Hospital for Children physicians, patients each received a brace with embedded sensors and were then divided into two groups. In the first group, 93 patients were told about the existence and purpose of the monitors, and data and time spent wearing the brace were discussed at follow-up visits. The 78 patients in the second group were not told about the purpose of the monitors, nor did they receive data on brace compliance.

As stated in the news release, “The average curve magnitude at the start of bracing was comparable at the start of the study: 33.2 degrees in the counseled group and 33.9 in the non-counseled group. Daily brace wear during the initial 180-day time period averaged 15 hours in the counseled group and 12.5 hours in the non-counseled group. Counseled patients who completed bracing averaged 13.8 hours per day of orthotic wear during the entire course of bracing, compared with 10.8 hours per day for patients who did not receive compliance reports. The spinal curve did not progress more than 6 degrees between the start of bracing and brace termination in 59% of patients in the counseled group, and 36% of patients in the non-counseled group. Children who did not need surgery wore their brace 2.1 hours more per day on average.”

Dr. Karol told OTW, “A paper by Dr. Tony Herring and Don Katz from our hospital showed that the hours that a patient wears a brace for scoliosis influences the possibility of surgery, yet the vast majority of our patients were not wearing their braces. I began to search for ways to increase my own patients’ use of their orthoses.”

“For those patients who were in the ‘counseling group, ’ a report of their hours of daily brace wear, and their average brace use since the last visit, was printed out and reviewed with them by their orthotist and their doctor. This had two effects. Firstly, the patients knew their use (or non-wear) would be documented, and they wore their braces more. Also, those patients who were struggling with brace wear were identified and encouraged to increase their compliance. This study nicely shows that open sharing of information via communication with teen patients has a positive effect.”