• Tomoyuki Asada, Toshiaki Kotani, Tsuyoshi Sakuma, Yasushi Iijima, Kotaro Sakashita, Yosuke Ogata, Tsutomu Akazawa, Shohei Minami, Seiji Ohtori, Masao Koda, and Masashi Yamazaki.
• Department of Orthopedic surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
• Spine. 2024 Apr 10.

Study DesignRetrospective cohort study.ObjectiveTo identify factors contributing to optimal bracing compliance in adolescent idiopathic scoliosis (AIS).Summary Of Background DataPoor brace compliance is a key factor affecting brace treatment success in AIS. Predictive factors influencing optimal brace compliance to achieve brace treatment success remain unknown.Materials And MethodsThis study included AIS patients, aged 10-15, with a Cobb angle of 20-40 degrees. Demographics data, radiographic assessments, and patient-reported outcomes (including the SRS-22r patient questionnaire) were collected. Brace compliance was monitored using in-brace thermometers, defining optimal bracing time as more than 18 hours/day. Multivariable logistic regression analysis was employed to identify predictors of optimal bracing time from the demographic and patient- reported outcomes score before bracing.ResultsAmong 122 patients, 59.0% achieved optimal bracing time by six months. The achieved group indicated higher scores in satisfaction domain before bracing (3.3±0.7 vs. 3.1±0.6; P=0.034). Multivariable logistic regression analysis demonstrated that Satisfaction domain before bracing was an independent factor associated with achievement of the optimal bracing time (OR 1.97 [95%CI 1.00 - 3.89], P=0.049). The model with bracing at 1-month follow-up also demonstrated the bracing at 1-month was a significant factor (OR 1.52 [95%CI 1.30 - 1.79], P<0.001).ConclusionOptimal bracing compliance in AIS is significantly influenced by pre-bracing satisfaction and brace compliance at earlier time point. These findings highlight the need to address psychological factors and early compliance in AIS bracing treatment. SRS-22r can be useful to identify the need for psychological support.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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