IMPACT OF THORACOLUMBAR BRACING ON ADOLESCENT IDIOPATHIC SCOLIOSIS DEFORMITY

Objective: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and often requires conservative treatment to prevent curve progression. Bracing is the primary non-surgical intervention, but its impact on multidimensional spinal parameters remains incompletely characterized. Materials and Methods: This study included 33 patients with AIS (mean age 12.76±1.20 years, range 10-14, 90.9% female) who had initial Cobb angles of 20°-40° and Risser stages 0-3. All were treated with thoracolumbosacral orthosis and were followed for 12 months. Radiographic assessments included Cobb angle, cervical lordosis (C2-7), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic parameters [sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT)], vertebral rotation, and T1 slope. Results: Bracing yielded substantial coronal correction: thoracic Cobb angle 24.2°→10.3° (Δ=13.9°; -57%; p=0.003), thoracolumbar Cobb angle 25.7°→11.2° (Δ=14.5°; -57%; p=0.003), and lumbar Cobb angle 26.3°→12.3° (Δ=14.0°; -53%; p=0.028). In the sagittal plane, TK decreased modestly (34.7°→31.0°, p=0.007), yet remained within the physiological range (20-45°); LL showed a small, non-significant change (44.8°→43.8°, p=0.118), and the proportion of patients with LL <40° decreased from 27.3% to 24.2%. C2-7 remained stable (11.37°→10.33°, p=0.161), whereas the T1 slope declined (21.33°→19.48°, p=0.015), indicating preserved cervicothoracic adaptation. Spinopelvic parameters were unchanged: SS 34.34°→33.64° (p=0.376), PT 12.40°→14.31° (p=0.136), PI 46.34°→47.05° (p=0.633); SVA also remained stable (9.06→11.22 mm, p=0.406). Raimondi rotation decreased (from 8.74° to 6.05°, p=0.024). Conclusion: Brace therapy provides effective three-dimensional correction in AIS, with significant improvements in coronal, sagittal, and transverse parameters while preserving global spinal balance and pelvic morphology. These results support bracing as a safe and effective conservative treatment for skeletally immature patients.