Brace Prescription Patterns in Patients Referred to Orthopaedic Clinics for Adolescent Idiopathic Scoliosis (AIS)

Even if braces for scoliosis are broadly used, there are no data on the orthopaedic medical practice to evaluate the circumstances of brace prescription. This study aims at comparing scoliosis brace prescription patterns with generally recognized standards. A cross-sectional study was carried out in 2006-2007 on all confirmed AIS patients referred to a paediatric scoliosis clinic for a first visit. Agreement between the actual brace prescription patterns and standards for immediate prescription was analyzed, following the recommendations of the Quebec Scoliosis Network (QSN), as well as the Scoliosis Research Society (SRS) therapeutic inclusion criteria. In addition, chi-2 tests and logistic regression models were used to identify variables related to brace prescription. Amongst the 321 AIS patients, immediate brace treatment was recommended in 70 cases, for about 50% of concordance with the defined criteria. Variables describing the patients' maturity (age, Risser, onset of menses) and deformity magnitude (Cobb angle and rib hump), as well as the treating physician, were the main determinants of brace prescription. Despite the professional consensus on immediate bracing norms, under and over-prescription of brace were documented in this study. Better understanding of these patterns would require documentation of motives associated with prescription at the individual level.