1. Providence Night-time Bracing are effective in Treatment of Adolescent Idiopathic Scoliosis, even in Curves larger than 35°
Authors Ane Simony MD, PhD, Emil Jesper Hansen MD, PhD, Stig Mindedahl Jespersen, Mikkel Ø. Andersen MD
Background: Since 2006 the Providence Night time Brace, has been used for conservative treatment of scoliosis. Previous studies comparing the outcome after full time bracing and Night time bracing, has reported comparable outcome with curves < 35°. No previous studies has reported, the effect of treatment in curves > 35°. Purpose: The aim of this study was to report the outcome after treatment in a cohort of Adolescent Idiopathic Scoliosis patients, with curves between 20-45°. Materials and Methods: 124 patients with Adolescent idiopathic scoliosis were included in this study, diagnosed with Cobb > 20°, a remaining growth potential and no previous scoliosis treatment. Providence Night time treatment, 8 hours nightly, was initiated with a in brace correction > 70 %. Treatment was continued until 2 years post menarchal for the females, and until 6 months growth arrest in boys. The patients were evaluated by standing radiographs during treatment, 6 and 12 months after termination. To investigate the effect, of treatment according to the severity of the curve the patient were divided into groups, according to the initial Cobb before treatment. Results: 124 patients were included in this study and 80 patients terminated brace treatment and follow up. The mean in-brace correction was 83 %, and curve progression was observed in 9 patients. Brace treatment was successfull in 88.7 % of patients, also in patients with curves > 35° when treatment was initiated. 5 % of the patients were referred to surgical treatment due to progression. (see table 2 for patient that failed treatment) Conclusions: Providence night time braces are effective, as a treatment in adolescent idiopathic scoliosis patients. Also in patients with Cobb > 35°.
This study reports a success rate of 88.7 % after treatment. The results after bracing are comparable to fulltime treatment with Boston braces or other TLSO.
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