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European Spine Journal

, Volume 28, Issue 9, pp 2020–2024 | Cite as

Providence nighttime bracing is effective in treatment for adolescent idiopathic scoliosis even in curves larger than 35°

  • Ane SimonyEmail author
  • Inge Beuschau
  • Lena Quisth
  • Stig Mindedahl Jespersen
  • Leah Yaccat Carreon
  • Mikkel Osterheden Andersen
Original Article

Abstract

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°.

Methods

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.

Results

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.

Conclusions

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.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Adolescent idiopathic scoliosis Providence nighttime bracing Conservative treatment In-brace correction Outcome 

Notes

Acknowledgements

The study was approved by the Medical Ethical Board in the Region of Southern Denmark and Data Protection Agency.

Funding

The study did not recieve any funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conlict of interest.

Supplementary material

586_2019_6077_MOESM1_ESM.pptx (134 kb)
Supplementary file1 (PPTX 134 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ane Simony
    • 1
    Email author
  • Inge Beuschau
    • 1
  • Lena Quisth
    • 1
  • Stig Mindedahl Jespersen
    • 1
  • Leah Yaccat Carreon
    • 1
  • Mikkel Osterheden Andersen
    • 1
  1. 1.Sector for Spine Surgery and ResearchMiddelfart HospitalMiddelfartDenmark

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