Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study

Eur Spine J. 2017 Jun;26(6):1670-1675. doi: 10.1007/s00586-017-4985-y. Epub 2017 Feb 6.


Purpose: Overweight 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.

Methods: Design: retrospective cohort study.

Population: 351 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 criteria: no previous treatment, full-time prescription of brace at first visit (18-23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated.

Outcome: improved, progressed, and stable according to the 5° Cobb agreed threshold.

Statistics: a 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.

Results: BMI 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.

Discussion: Brace 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.

Keywords: BMI; Braces; Overweight; Scoliosis.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Braces*
  • Child
  • Cohort Studies
  • Female
  • Humans
  • Linear Models
  • Male
  • Overweight*
  • Patient Outcome Assessment
  • Retrospective Studies
  • Scoliosis / therapy*