• Fabio Zaina, Sabrina Donzelli, and Stefano Negrini.
• ISICO (Italian Scientific Spine Institute), Via Roberto Bellarmino 13/1, 20141, Milan, MI, Italy. fabio.zaina@isico.it.
• Eur Spine J. 2017 Jun 1; 26 (6): 1670-1675.

PurposeOverweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AIS patients.MethodsDesign: retrospective cohort study.Population351 AIS patients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2.Inclusion Criteriano previous treatment, full-time prescription of brace at first visit (18-23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated.Outcomeimproved, progressed, and stable according to the 5° Cobb agreed threshold.Statisticsa stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied.ResultsBMI is poorly correlated with final results. Confounders' adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively.DiscussionBrace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.

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