To brace or not? The answer is “it depends”. Preliminary results from BrAIST

Results The overall failure rate was 31% after bracing and 52% after observation. Age, gender, Risser, Sanders’ digital maturity stage (DMS), curve type and Cobb angle were all associated with outcome. DMS stages were more predictive of failure than Risser grade, even with age in the model. The best-fitting model included the DMS (1-2, 3, or 4+), Cobb angle, and treatment (p<0.0001, c statistic=0.841). Increasing Cobb angle was associated with increased risk of failure across all DMS’s; bracing significantly decreased the risk. In DMS 1-2, the risk of failure ranged from 73% (Cobb 20) to 93% (Cobb 39). Bracing reduced the risk to 50% and 84%, respectively. Risk was lower in DMS 3 patients, ranging from 36% (Cobb 20) to 76% (Cobb 40), reducing to 19% to 52% with bracing. The lowest risk of failure was noted at DMS 4+, ranging from 9% (Cobb 20) to 31% (Cobb 39), reducing to 3% to 15% with bracing.