Long-term outcomes of adolescent idiopathic scoliosis: Natural history of untreated, braced, surgically treated patients in adult life

Table 2 Long-term outcomes of bracing in adolescent idiopathic scoliosis

Ref.	Study type	Sample size and follow-up	Curve range (°)	Outcomes	Key findings
Weinstein et al[7], 2013	Randomized controlled trial	242 patients, mean 3.4 years	Not specified	Curve progression (≥ 50°)	72% braced avoided progression ≥ 50° vs 48% in observation group
Danielsson et al[6], 2010	Retrospective comparative cohort	109 patients, mean 22 years	> 45° (braced vs untreated)	HRQoL, curve stability	No significant HRQoL difference; better curve stability in braced group
Dolan and Weinstein[3], 2007	Narrative review	Review of long-term data (20+ years)	Not specified	Surgical rates	Bracing reduced surgical rates in compliant patients
Donzelli et al[44], 2023	Prospective cohort study	1067 patients, end of treatment	Not specified	In-brace correction, treatment success	High in-brace correction and compliance predicted bracing success
Simony et al[42], 2015	Retrospective long-term cohort	117 patients, 25-year follow-up	Not specified	HRQoL, function	HRQoL similar to general population; good physical function
Capek et al[46], 2023	Prospective comparative study	358 patients, mean 5-7 years	> 30°	Bracing regimen efficacy	Full-time bracing more effective for curves > 30°
Danielsson[25], 2007	Retrospective cohort study	106 patients, 16-year follow-up	Not specified	Curve stability, QoL	Stable curves; QoL similar to surgically treated patients
Negrini et al[50], 2015	Systematic review	Cochrane review of multiple studies	Various	Bracing effectiveness	Bracing effective if worn ≥ 18 hours/day
Negrini et al[40], 2018	International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment guideline and expert opinion	Expert consensus (guidelines)	25°-40°	Bracing indications, standards	Guidelines standardized indications, compliance, and in-brace correction goals
van den Bogaart et al[45], 2019	Best evidence synthesis	Review and synthesis of 13 studies	20°-45°	Predictors of success	High in-brace correction and early initiation are strongest predictors
Karol et al[41], 2016	Prospective observational study	Not specified	Not specified	Compliance, brace outcome	Counseling improved brace wear time and outcomes
Danielsson et al[43], 2001	Retrospective case-control study	Long-term, 20+ years	Not specified	Brace vs surgical outcomes	No major differences in long-term function or satisfaction
Karavidas[49], 2019	Review article	Narrative summary	Not specified	Evidence summary	Emphasized timing, compliance, and psychological support for optimal results
Costa et al[62], 2021	Systematic review/meta-analysis	18 studies included	Various	Bracing concepts and outcomes	Rigid braces more effective than soft; compliance critical
Swaby et al[47], 2023	Prospective RCT protocol	Protocol; ongoing Bracing Adolescent Idiopathic Scoliosis study	25°-40°	Night time vs full-time bracing	Ongoing trial comparing both
Aulisa et al[48], 2014	Prospective cohort	113 juvenile idiopathic scoliosis patients, mean follow-up 6 years	≥ 25°	Juvenile idiopathic scoliosis bracing efficacy	84% success rate in avoiding progression > 45°; high compliance linked to success
Danielsson et al[43], 2001	Matched follow-up study	Long-term (20+ years)	Not specified	HRQoL post-treatment	Braced patients had similar QoL as surgical group and healthy controls

HRQoL: Health-related quality of life; QoL: Quality of life; RCT: Randomised controlled trial.