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TLSO Treatment of Idiopathic Scoliosis: An Analysis of the Wilmington Jacket

HANKS, GREGORY A., MD*; ZIMMER, BRUCE, MD; NOGI, JAY, MD

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A retrospective study of one hundred female patients treated for idiopathic scoliosis using an underarm plastic thoracolumbar-sacral orthosis (TLSO) jacket was undertaken. The purpose of the study was to evaluate the efficacy of the Wilmington jacket, to search for clinical variables which could statistically predict success, and to evaluate preliminary results of parttime bracing in 25 patients. The following parameters were statistically evaluated by multiple regression analysis: age, sex, curve location, number of vertebrae in curve, Cobb angle, maturity (Risser sign, menarche), curve flexibility, and hours in the jacket. The overall success rate was 81%, and onset of menarche and Risser sign were statistically significant prognostic variables. Ten patients (10%) underwent posterior spinal fusion for curve progression. Bracing with an underarm scoliosis jacket is a successful method of treatment of idiopathic scoliosis in the immature spine. We do not recommend brace treatment for postmenarchal patients or patients with a Risser sign of Grade 1 or greater until curve progression has been observed. Furthermore, the Wilmington jacket appears to give similar results for part-time brace wearers.

*From the Division of Orthopaedics, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania, and the Division of Orthopaedics, Children's Hospital, and the Medical College of Virginia Hospitals, Richmond, Virginia.

Submitted for publication March 13, 1986, and revised September 18, 1986.

© Lippincott-Raven Publishers.