Evaluating Cost-Effective Timing for Starting Brace Treatment in Adolescents with Idiopathic Scoliosis

What this Trial Is About

Researchers are investigating the cost-effectiveness of current bracing protocols for adolescent idiopathic scoliosis AIS, focusing on whether early bracing at mild curve levels and surgery at 40 degrees provides better value while maintaining quality of life. This prospective study aims to improve decision-making and care for AIS patients by comparing different timing strategies for starting brace treatment. The study involves analyzing health quality of life using Scoliosis Research Society 22-item and EuroQol-5 dimension questionnaires alongside direct and indirect medical costs. The study includes AIS patients with remaining growth potential who are prescribed underarm Boston or Milwaukee braces. Data will be collected prospectively over at least two years with a minimum of five clinic visits, including clinical and radiographic assessments. Costs such as clinic visits, treatments, bracing fabrication, physiotherapy, psychological assessments, and surgery if needed will be analyzed. The study will also use mathematical modeling to simulate patient outcomes and identify the most cost-effective timing for brace initiation based on curve severity and maturity. Participants will undergo regular measurements of weight, height, arm span, radiographs, and doctor assessments at each visit. Quality of life and utility questionnaires will be completed at every visit. Researchers will monitor changes in spine curvature and posture, brace compliance, and health-related quality of life over up to three years. The study aims to provide evidence for the best balance of cost, quality of life, and treatment timing to guide care for AIS patients.

Determining Best Indications for Bracing for Adolescent Idiopathic Scoliosis