Sorry if the actual article was posted before, I have not all the day to read all what is posted here as you. Please try to understand what thinking really means before giving that kind of nonsense advices.
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Originally posted by flerc View PostSorry if the actual article was posted before, I have not all the day to read all what is posted here as you.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
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Another BrAIST article... I think they will publish several before it's all said and done.
October 01, 2013 - Volume 38 - Issue 21
pp: i-i,1799-1903,E1291-E1360
Design of the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST)
Weinstein, Stuart L.; Dolan, Lori A.; Wright, James G.; More
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In Brief
Abstract
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Study Design. Descriptive.
Objective. To describe the design and development of Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST).
Summary of Background Data. Bracing has remained the standard of care for the nonoperative treatment of adolescent idiopathic scoliosis since the introduction of the Milwaukee brace in the late 1940s, but it has never been subjected to a rigorous evaluation of either its efficacy or its effectiveness. The BrAIST was designed to address the primary question: Do braces (specifically a thoracolumbosacral orthosis) lower the risk of curve progression to a surgical threshold (≥50°) in patients with adolescent idiopathic scoliosis relative to watchful waiting alone?
Methods. The authors describe the rationale for BrAIST, including the limitations of the current literature evaluating bracing for adolescent idiopathic scoliosis. Second, the authors describe the preliminary work, including the preparation of the National Institutes of Health clinical trials planning grant. Finally, the authors describe the trial design in detail.
Results. BrAIST was conducted in 25 sites in North America. Subjects were treated either with a thoracolumbosacral orthosis or watchful waiting and followed every 6 months until they reached skeletal maturity or the surgical threshold of 50° Cobb angle.
Conclusion. Clinical decision making will be improved by translation of the BrAIST results into evidence-based prognosis and estimates of how the prognosis, specifically the risk of progressing to surgery, may be altered by the use of bracing.
Level of Evidence: N/ASharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
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Originally posted by Pooka1 View PostAnother BrAIST article... I think they will publish several before it's all said and done.
'In conclusion, bracing significantly decreased the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis. Longer hours of brace wear were associated with greater benefit.'
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Why it is important to know NOT just that these "successes" were <50* at maturity but what exactly the curves were at maturity... five will get you ten that kids are only willing to wear a brace if it avoids surgery for life, NOT if it avoids surgery until you are 15 ore 16. If it doesn't make sense then it probably isn't true.
Over the weekend, I've been in email contact with a 33 yo woman from Houston Texas who shared her story of curve progression from the 30's now into the 40's with her thoracolumbar curve now after pregnancy, where surgery has been recommended.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
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Obviously, kids are not stupids. Who said that?. If NECESSARILY progression until surgery need should to happen to every kid using braces at 15, 16 or then, then parents/surgeons opting for/recomending braces would be insane. Do you believe that? If it doesn't make sense then it probably isn't true.Last edited by flerc; 10-12-2013, 09:22 PM.
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These kids all probably think they are avoiding surgery for life if the brace is successful. That is clearly false.
It's isn't a matter of intelligence. It is a matter of having or not having specific knowledge.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
Comment
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That's a faith position, not a scientific one. What is the evidence they have a chance to avoid surgery for life? Virtually all these braced kids are >30* at maturity.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
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Originally posted by flerc View PostWho said that? Is far to be according the cases I know. And not every people with >30* at maturity are sentenced to have surgery.
Kids need to see some stats on actual progression rates starting from various curve magnitudes. I note that Dr. Hey doesn't seem shocked when someone comes into his office who needs surgery when they are in the 30s* at maturity. If it was rare then he should be shocked and not have so many cases on his blog.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
Comment
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I originally was diagnosed with a Thoracolumbar S curve, with curves of 35 and 36 degrees at age 13. I wore my brace and my x-rays some months after being done with bracing showed my curves in the low 20's at age 15. Somewhere between there and age 40 my lumbar curve returned to 30-35, and two years later the lumbar curve was 47. Curiously the thoracic curve stayed around 25 all those years.
So for me I ended up with relatively small curves at maturity but then had a huge, rapid progression after age 40. I know I am not the only one here with this type of story. Dr Hey talks about people similar to me all the time.
What gets me is the statistics strongly imply (at least 70% chance) that my curve would not have progressed without a brace. I was braced immediately based on cobb angle, I never had any documented progression. So it is impossible to say if I was one of the ones who was "saved" from surgery with the brace, or if I was one of the 3 children who are braced unnecessarily for every one child who is saved from surgery. Definitely something to think about.Gayle, age 50
Oct 2010 fusion T8-sacrum w/ pelvic fixation
Feb 2012 lumbar revision for broken rods @ L2-3-4
Sept 2015 major lumbar A/P revision for broken rods @ L5-S1
mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
2010 VBS Dr Luhmann Shriners St Louis
2017 curves stable/skeletely mature
also mom of Torrey, 12 y/o son, 16* T, stable
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Originally posted by flerc View PostYou didn't answer that.
Do you believe that everyone knowing to have >30* at maturity would prefer to have surgery anyway?
I think kids should know that even if they wear their brace as prescribed, if they are >30* at maturity, there is no guarantee they can avoid reaching surgical range. The brace is NO GUARANTEE to avoid surgery and I wonder how many kids are clear on this point.Sharon, mother of identical twin girls with scoliosis
No island of sanity.
Question: What do you call alternative medicine that works?
Answer: Medicine
"We are all African."
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