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.

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Introduction Six years ago, the primary conservative treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing to nighttime bracing. The purpose of this study is to evaluate the effectiveness of nighttime bracing in AIS. Patients and Methods Patients diagnosed with AIS and skeletal immature. With an apex of the primary curve from TH7 and below and with a Cobb angel between 20 and 45 degrees. The patients were asked to wear the brace at least 7 8 hours per night. No other previous treatments were accepted and a follow-up at least 6 months out of brace. The brace treatment was continued until 2 years post menarche or for male at the expected adult height. Cross-measured X-rays were used to compare the primary Cobb angel, the in-brace correction and the outcome Cobb angel. A decreased outcome Cobb angle as well as the overcorrection of the curve measured in brace was recorded as zero. The brace treatment was considered failed if progression more than 5 degrees occurred and if surgery were performed. Results A total of 55 patients, 8 males and 47 females, with the mean age at 14 years (range, 11–16.5 years) and the mean primary Cobb at 31 degrees (range, 20–41 degrees) were included in this study. The mean time of treatment was 18 months (range, 5–59 months). After ended treatment, the mean Cobb angle was 28 degrees (range, 7–50 degrees), and we observed in average no progression of the curves. The end results were 11 failures (range, 6–15 degrees); equal 20% and of these 11 patients, 3 patients had surgery performed (5%). Conclusion The results show a good curve control and an acceptable 20% failure rate, which is equal to other studies. The progression of the curves is controlled acceptable, even with the larger curves included in this study. The providence brace is an excellent alternative to standard conservative treatment. Larger studies are needed to establish the relationship between embrace correction and curve progression.

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