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

Abstract

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.

The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

“…The radiographic skeletal maturity at initiation of the treatment was reported in all papers. Of the studies, 32 used the Risser sign and one study only used menarche as a proxy for maturity [ 39 ]. Of those, 3% used the Risser sign between 0–1 (as subgroup), 70% between 0–2, 18% between 0–3, 3% between 0–4, 3% used Risser 0–1 and Tanner between 2–3, and 3% used Risser 0–2 and menarche period as well (pre-menarche or 1 year post-menarche) (see Table 5 and Table 6 ).…”

“…The Providence brace was studied in four non-comparative studies with low to moderate quality (total n = 56 + 63 + 102 + 34 + 80) [ 5 , 36 , 37 , 38 , 39 ]. Success rates were between 52% and 89% [ 36 , 39 ].…”

<p>Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date</p>

“…Simony et al (2019) in a retrospective cohort, including patients wearing Providence brace, with initial IBC >60%, less than 12 months post-menarche (no Risser sign referred), found a success rate of 89% 96. They recommended that at least 70% IBC is required for successful treatment.…”

The Influence of Lumbar Modifiers on Functional and Radiological Outcomes in the Brace Treatment of Lenke Type 1 Adolescent Idiopathic Scoliosis

“…To our knowledge, the present study is the first to evaluate the relationship between functional and radiological results and lumbar modifiers in Lenke type 1 curves treated with a brace, although there are many articles about lumbar modifiers in the literature. Many different types of braces are being tried in brace treatment of AIS [2,3]. was able to keep the curve progression below the surgical threshold, especially in AIS with a high risk of progression [3].…”

“…Adolescent idiopathic scoliosis (AIS) is a three-dimensional structural deformity of unknown origin, often occurring during puberty [1]. In patients with a Cobb angle greater than 25 and growth potential, a brace is used to stop the curve progression [2]. Brace treatment is one of the most common conservative treatments in AIS [3].…”