Ane Simony, Inge Beuschau, Lena Quisth, Stig Mindedahl Jespersen, Leah Yaccat Carreon, Mikkel Osterheden Andersen
August 2019, Volume 28, Issue 9, pp 2020 - 2024 Original Article Read Full Article 10.1007/s00586-019-06077-z
First Online: 24 July 2019
Summary of Background Data
Since 2006, the Providence nighttime brace has been used for a conservative treatment for scoliosis. Previous studies comparing the outcomes after full-time bracing and nighttime bracing have reported a comparable outcome with curves < 35°. The aim of this study was to report the outcome after treatment in a cohort of adolescent idiopathic scoliosis patients, with curves between 20° and 45°.
One hundred and twenty-four patients with adolescent idiopathic scoliosis were included in this study with Cobb > 20°, remaining growth potential and no previous scoliosis treatment. Providence nighttime treatment, 8 h nightly, was initiated. Treatment was continued until 2 years post-menarcheal for females and until 6-month growth arrest for males. The patients were evaluated using standing radiographs during treatment and 6 and 12 months after termination of bracing.
One hundred and twenty-four patients were included; 80 patients terminated brace treatment and were available for follow-up. Mean in-brace correction was 82%, and curve progression was observed in 9 patients. Brace treatment was success full in 89% of the patients, 88% of the patients braced with curves 20°–29°, 93% of the patients braced with 30°–39° and 77% of the patients braced with curves 40°–45°. Five of the 80 AIS patients were referred to surgery: 4 due to progression and 1 due to cosmetic concerns.
Providence nighttime braces are an effective treatment for adolescent idiopathic scoliosis patients. This study reports a success rate of 89%, and the results are comparable to full-time treatment with the Boston brace. In-brace correction is crucial in part-time bracing, and we recommend at least 70% curve correction, if part-time bracing should be considered.
These slides can be retrieved under Electronic Supplementary Material. [Figure not available: see fulltext.]
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