{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T12:14:47Z","timestamp":1774008887402,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The impact of thoracolumbosacral orthosis (TLSO) bracing on sagittal spinopelvic alignment and psychosocial outcomes in adolescent idiopathic scoliosis (AIS) remains debated. Methods: This retrospective comparative study included 120 girls (10\u201318 years) with AIS (baseline Cobb angle 20\u201340\u00b0) and skeletal immaturity (Risser 0\u20131). Patients were managed with a thoracolumbosacral orthosis (TLSO) brace (n = 60) or observation alone (n = 60). Standing posteroanterior and lateral full-spine radiographs were obtained at baseline and at 24 \u00b1 6 months; follow-up radiographs were acquired out of brace after a standardized 48 h brace-free interval. They were used to measure coronal and sagittal spinopelvic parameters. Patient-reported outcomes included the Scoliosis Research Society-22r (SRS-22r), Pediatric Quality of Life Inventory (PedsQL), Spinal Appearance Questionnaire (SAQ), Trunk Appearance Perception Scale (TAPS), and Beck Depression Inventory (BDI). The primary endpoint was curve progression (\u22655\u00b0 increase or exceeding 40\u00b0) at 24 months. Multivariable regression was used to adjust for baseline Cobb angle and maturity. Mean follow-up was 24 \u00b1 6 months. Results: Mean Cobb change was +1.2\u00b0 in the brace group vs. +7.3\u00b0 in the observation group (group \u00d7 time interaction p &lt; 0.001). Progression (\u22655\u00b0) occurred in 15% vs. 45%, respectively, and 18% of observed patients exceeded 40\u00b0 (risk ratio 0.33, 95% CI 0.17\u20130.65; number needed to treat 4, 95% CI 3\u20137). Sagittal spinopelvic parameters showed no significant group-by-time interaction. No significant between-group differences were observed in SRS-22r, PedsQL, SAQ, TAPS, or BDI at baseline or follow-up. Patients with curve progression exhibited worse appearance-related scores. In multivariable analysis, depressive symptoms were the strongest determinant of PedsQL (\u03b2 = \u22120.55, p &lt; 0.001). Conclusions: Brace treatment was associated with reduced curve progression in girls with moderate AIS. Over approximately two years of follow-up, we did not observe clinically relevant between-group differences in sagittal spinopelvic alignment or psychosocial patient-reported outcomes. Given the retrospective, non-randomized design and self-reported adherence, psychosocial findings should be interpreted cautiously and require confirmation in prospective, objectively monitored, psychologically informed bracing studies.<\/jats:p>","DOI":"10.3390\/jcm15062375","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:44:41Z","timestamp":1773999881000},"page":"2375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Brace Treatment Is Associated with Lower Curve Progression in Moderate Adolescent Idiopathic Scoliosis, While Psychosocial Outcomes Are Driven by Depressive Symptoms and Curve Progression"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-5651","authenticated-orcid":false,"given":"Ahmet","family":"Keskin","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Metin Sabanci Baltaliman\u0131 Bone Diseases Training and Research Hospital, Istanbul 34470, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9097-5992","authenticated-orcid":false,"given":"Niyazi","family":"Igde","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Levent Hospital, Istanbul 34415, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8625-0646","authenticated-orcid":false,"given":"Mustafa","family":"Serpi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Metin Sabanci Baltaliman\u0131 Bone Diseases Training and Research Hospital, Istanbul 34470, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8562-217X","authenticated-orcid":false,"given":"Gorkem","family":"Kayis","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Metin Sabanci Baltaliman\u0131 Bone Diseases Training and Research Hospital, Istanbul 34470, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-3112","authenticated-orcid":false,"given":"Huseyin Sina","family":"Coskun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ondokuz May\u0131s University, Samsun 55200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Akif","family":"Kaygusuz","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Metin Sabanci Baltaliman\u0131 Bone Diseases Training and Research Hospital, Istanbul 34470, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11832-012-0457-4","article-title":"Epidemiology of Adolescent Idiopathic Scoliosis","volume":"7","author":"Konieczny","year":"2013","journal-title":"J. Child. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Ruiz, J.M., Mohamed, N., Hassan, M., Fald, K., de Los R\u00edos Ruiz, E., P\u00e9rez Cabello, P., Redondo, \u00c1.R., da Rosa, B., Burke, T.N., and Westover, L. (2025). Clinical and Topographic Screening for Scoliosis in Children Participating in Routine Sports: A Prevalence and Accuracy Study in a Spanish Population. J. Clin. Med., 14.","DOI":"10.3390\/jcm14010273"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kuroki, H. (2018). Brace Treatment for Adolescent Idiopathic Scoliosis. J. Clin. Med., 7.","DOI":"10.3390\/jcm7060136"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1056\/NEJMoa1307337","article-title":"Effects of Bracing in Adolescents with Idiopathic Scoliosis","volume":"369","author":"Weinstein","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Costa, L., Schlosser, T.P.C., Jimale, H., Homans, J.F., Kruyt, M.C., and Castelein, R.M. (2021). The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10102145"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1097\/01.brs.0000435048.23726.3e","article-title":"Design of the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST)","volume":"38","author":"Weinstein","year":"2013","journal-title":"Spine"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Dufvenberg, M., Diarbakerli, E., Charalampidis, A., \u00d6berg, B., Tropp, H., Aspberg Ahl, A., M\u00f6ller, H., Gerdhem, P., and Abbott, A. (2021). Six-Month Results on Treatment Adherence, Physical Activity, Spinal Appearance, Spinal Deformity, and Quality of Life in an Ongoing Randomised Trial on Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS). J. Clin. Med., 10.","DOI":"10.3390\/jcm10214967"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E596","DOI":"10.1097\/BRS.0000000000002918","article-title":"An Insight into the Health-Related Quality of Life of Adolescent Idiopathic Scoliosis Patients Who Are Braced, Observed, and Previously Braced","volume":"44","author":"Cheung","year":"2019","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/BRS.0b013e318231493c","article-title":"Body Appearance and Quality of Life in Adult Patients with Adolescent Idiopathic Scoliosis Treated with a Brace or under Observation Alone during Adolescence","volume":"37","author":"Danielsson","year":"2012","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e519","DOI":"10.1097\/BPO.0000000000000734","article-title":"Body Image and Quality of Life and Brace Wear Adherence in Females with Adolescent Idiopathic Scoliosis","volume":"37","author":"Schwieger","year":"2017","journal-title":"J. Pediatr. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.2106\/JBJS.L.00867","article-title":"Body Image in Patients with Adolescent Idiopathic Scoliosis: Validation of the Body Image Disturbance Questionnaire--Scoliosis Version","volume":"96","author":"Auerbach","year":"2014","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.31616\/asj.2018.0307","article-title":"The Effect of Bracing on Spinopelvic Rotation and Psychosocial Parameters in Adolescents with Idiopathic Scoliosis","volume":"13","author":"Khoshhal","year":"2019","journal-title":"Asian Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pepke, W., El Zeneiny, A., Almansour, H., Bruckner, T., Hemmer, S., and Akbar, M. (2021). Influence of Ch\u00eaneau-Brace Therapy on Lumbar and Thoracic Spine and Its Interdependency with Cervical Spine Alignment in Patients with Adolescent Idiopathic Scoliosis (AIS). J. Clin. Med., 10.","DOI":"10.3390\/jcm10091849"},{"key":"ref_14","first-page":"287\u2013297; discussion 297\u2013300","article-title":"A new 2D and 3D imaging approach to musculoskeletal physiology and pathology with low-dose radiation and the standing position: The EOS system","volume":"189","author":"Dubousset","year":"2005","journal-title":"Bull. Acad. Natl. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"401","DOI":"10.31616\/asj.2022.0011","article-title":"Effect of Brace Treatment on Craniovertebral to Lumbopelvic Sagittal Parameters in Adolescents with Idiopathic Scoliosis: A Systematic Review","volume":"17","author":"Ghorbani","year":"2023","journal-title":"Asian Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Misterska, E., Tomaszewski, M., G\u00f3rski, F., Gapsa, J., S\u0142ysz, A., and G\u0142owacki, M. (2024). Assessing the Efficacy of Cognitive-Behavioral Therapy on Body Image in Adolescent Scoliosis Patients Using Virtual Reality. J. Clin. Med., 13.","DOI":"10.3390\/jcm13216422"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"203","DOI":"10.31616\/asj.2022.0162","article-title":"Does Bracing Control the Progression of Adolescent Idiopathic Scoliosis in Curves Higher Than 40\u00b0? A Systematic Review and Meta-Analysis","volume":"17","author":"Babaee","year":"2023","journal-title":"Asian Spine J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1302\/2633-1462.65.BJO-2024-0271.R1","article-title":"Factors Contributing to Bracing Success in Juvenile Idiopathic Scoliosis and Current Limitations: A Systematic Review and Meta-Analysis","volume":"6","author":"Chan","year":"2025","journal-title":"Bone Jt. Open"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/BRS.0000000000004879","article-title":"BrAIST-Calc: Prediction of Individualized Benefit from Bracing for Adolescent Idiopathic Scoliosis","volume":"49","author":"Dolan","year":"2024","journal-title":"Spine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.otsr.2020.06.010","article-title":"Alterations of Sagittal Alignment and Thoracic Cage Parameters after Long-Term Bracing in Adolescents with Idiopathic Scoliosis","volume":"106","author":"Zhang","year":"2020","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Zhou, H., Liang, Z., Li, P., Shi, H., Liang, A., Gao, W., Huang, D., and Peng, Y. (2023). Correlation Analysis of Surgical Outcomes and Spino-Pelvic Parameters in Patients with Degenerative Lumbar Scoliosis. Front. Surg., 10.","DOI":"10.3389\/fsurg.2023.1319884"},{"key":"ref_22","first-page":"319","article-title":"Evaluation of Self-Perceived Body Image in Adolescents with Mild Idiopathic Scoliosis","volume":"12","author":"Belli","year":"2022","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kinel, E., Korbel, K., Kozinoga, M., Czaprowski, D., St\u0119pniak, \u0141., and Kotwicki, T. (2021). The Measurement of Health-Related Quality of Life of Girls with Mild to Moderate Idiopathic Scoliosis-Comparison of ISYQOL versus SRS-22 Questionnaire. J. Clin. Med., 10.","DOI":"10.3233\/SHTI210529"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zaina, F., Ferrario, I., Caronni, A., Scarano, S., Donzelli, S., and Negrini, S. (2023). Measuring Quality of Life in Adults with Scoliosis: A Cross-Sectional Study Comparing SRS-22 and ISYQOL Questionnaires. J. Clin. Med., 12.","DOI":"10.3390\/jcm12155071"},{"key":"ref_25","first-page":"97","article-title":"Body Image and Body Schema in Adolescents with Idiopathic Scoliosis: A Scoping Review","volume":"8","author":"Bertuccelli","year":"2023","journal-title":"Adolesc. Res. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mitsiaki, I., Thirios, A., Panagouli, E., Bacopoulou, F., Pasparakis, D., Psaltopoulou, T., Sergentanis, T.N., and Tsitsika, A. (2022). Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature. Children, 9.","DOI":"10.3390\/children9050597"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bag\u00f3, J., Matamalas, A., Pizones, J., Beteg\u00f3n, J., S\u00e1nchez-Raya, J., and Pellis\u00e9, F. (2024). Back Pain in Adolescents and Young Adults with Idiopathic Scoliosis-Identifying Factors Associated with Significant Pain-A Multivariate Logistic Regression Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13082366"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1177\/21925682221126451","article-title":"Predicting Health-Related Quality of Life Outcomes Following Major Scoliosis Surgery in Adolescents: A Latent Class Growth Analysis","volume":"14","author":"Kerr","year":"2024","journal-title":"Glob. Spine J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"11795441231166010","DOI":"10.1177\/11795441231166010","article-title":"Disordered Eating and Body Image Concerns in Young Adult Women with Scoliosis","volume":"16","author":"Limbers","year":"2023","journal-title":"Clin. Med. Insights Arthritis Musculoskelet. Disord."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2375\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T10:11:09Z","timestamp":1774001469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062375"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062375","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}