Providence nighttime bracing, in treatment of adolescent idiopathic scoliosis

A. Simony, Inge Beuschau, Lena Quisth, M. O. Andersen

Research output: Contribution to journalConference abstract in journalResearchpeer-review

Abstract

Introduction: Since 2008 the non-surgical treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing with Boston brace, to Providence night-time bracing. Methods: Since 2008, skeletally immature patients diagnosed with AIS and a primary curve with apex at T7 or below, were treated with the Providence night-time brace. The patients were evaluated every 6 months, with standing x-rays. Compliance with the treatment was recorded during the study. Bracing was continued up to two years post menarche or, for males upon reaching the expected adult height. Cobb angle of the major curve pre-treatment, in-brace correction and at last follow-up were determined. Curve progression of more than 5 degrees and need for surgical intervention were considered brace failures. The patients received the SRS22r questionnaire at least 8 months after termination of brace treatment. Results: A total of 62 patients, 10 males and 52 females, mean age of 14 years with a mean Cobb of 31.3degree degrees were included. There were 31 primary thoracic curves, 19 thoraco-lumbar curves, 11 lumbar curves and 1 double curve. The mean length of brace treatment was 17.8 months (6-59 months). The mean in-brace correction was 81 % (24-100 %). After the end of bracing, the mean Cobb angle was 29.1degree (7-50), an average of no progression. There were 11 (18 %) brace failures, but only 5 (10 %) patients had surgery. All patients returned the SRS22 r questionnaire, and the follow up was 12 months (8-37m). The SRS22r Function score was 4, 32, Mental Health 3, 81, SRS22r total 3, 9 and satisfaction with management 3, 90. The Pain domain was 3, 8. Conclusion: This study shows a good curve control with the Providence Night time brace and an acceptable 20 % curve progression rate. The night time brace is an excellent alternative to standard conservative treatment. The patients tolerate the night-time brace treatment well, and compliance is high. Function, Self-image, Mental Health, and SRS 22r total are similar to surgically treated patients and health controls, but it seems like patients treated with Providence braces are more likely to experience back pain than healthy adolescents and surgically treated scoliosis patients.
Original languageEnglish
Article numberQF41
JournalEuropean Spine Journal
Volume24
Issue numberS6
Pages (from-to)S728
Number of pages1
ISSN0940-6719
DOIs
Publication statusPublished - 2015
EventEUROSPINE 2015 - Copenhagen, Denmark
Duration: 2. Sep 20154. Sep 2015

Conference

ConferenceEUROSPINE 2015
Country/TerritoryDenmark
CityCopenhagen
Period02/09/201504/09/2015

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