A1 Refereed original research article in a scientific journal
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?
Authors: Ohrt-Nissen S, Lastikka M, Andersen TB, Helenius I, Gehrchen M
Publisher: SAGE PUBLICATIONS LTD
Publication year: 2019
Journal: Journal of Orthopaedic Surgery
Journal name in source: JOURNAL OF ORTHOPAEDIC SURGERY
Journal acronym: J ORTHOP SURG-HONG K
Article number: UNSP 2309499019860017
Volume: 27
Issue: 2
Number of pages: 8
ISSN: 1022-5536
eISSN: 2309-4990
DOI: https://doi.org/10.1177/2309499019860017
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/42471242
Purpose: To compare treatment efficacy between the Boston full-time brace and the Providence part-time brace in main thoracic adolescent idiopathic scoliosis (AIS). Methods: Patients were treated with either the Boston brace (n = 37) or the Providence brace (n = 40). Inclusion criteria were Risser grade <= 2, major curve between 25 degrees and 40 degrees with the apex of the curve between T7 and T11 vertebrae. Two-year follow-up was available in all patients unless brace treatment had reached endpoint. The primary outcome measure was main curve progression to >= 45 degrees. Results: Median age was 12.6 years and median treatment length at follow-up was 25 months (interquartile range (IQR): 18-32)) with no difference between the groups (p >= 0.116). Initial median main Cobb angle was 29 degrees (IQR: 27-33) and 36 degrees (IQR: 33-38) in the Boston and Providence groups, respectively (p < 0.001). At follow-up, 13 patients (35%) had progressed to >= 45 degrees in the Boston group versus 16 patients (40%) in the Providence group (p = 0.838). Twenty-three patients (62%) had progressed by more than 5 degrees in the Boston group versus 22 patients (55%) in the Providence group (p = 0.685). The secondary thoracolumbar/lumbar curve progressed by more than 5 degrees in 14 (38%) and 18 (45%) in the Boston and Providence groups, respectively (p = 0.548). Conclusions: Despite a larger initial curve size in the Providence group, progression of more than 5 degrees or to surgical indication area was similar in the Boston group. Our results indicate that nighttime bracing is a viable alternative to full-time bracing also in main thoracic AIS.
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