Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?
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...
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doaj-5bf85c4d13da4ef797f7ec4dd05781432020-11-25T03:28:47ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902019-07-012710.1177/2309499019860017Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?Søren Ohrt-Nissen0Markus Lastikka1Thomas Borbjerg Andersen2Ilkka Helenius3Martin Gehrchen4 Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Pediatric Orthopedic Surgery, Turku University Hospital, Turku, Finland Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Pediatric Orthopedic Surgery, Turku University Hospital, Turku, Finland Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkPurpose: 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° and 40° 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°. 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° (IQR: 27–33) and 36° (IQR: 33–38) in the Boston and Providence groups, respectively ( p < 0.001). At follow-up, 13 patients (35%) had progressed to ≥45° 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° 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° 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° 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.https://doi.org/10.1177/2309499019860017 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Søren Ohrt-Nissen Markus Lastikka Thomas Borbjerg Andersen Ilkka Helenius Martin Gehrchen |
spellingShingle |
Søren Ohrt-Nissen Markus Lastikka Thomas Borbjerg Andersen Ilkka Helenius Martin Gehrchen Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? Journal of Orthopaedic Surgery |
author_facet |
Søren Ohrt-Nissen Markus Lastikka Thomas Borbjerg Andersen Ilkka Helenius Martin Gehrchen |
author_sort |
Søren Ohrt-Nissen |
title |
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? |
title_short |
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? |
title_full |
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? |
title_fullStr |
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? |
title_full_unstemmed |
Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing? |
title_sort |
conservative treatment of main thoracic adolescent idiopathic scoliosis: full-time or nighttime bracing? |
publisher |
SAGE Publishing |
series |
Journal of Orthopaedic Surgery |
issn |
2309-4990 |
publishDate |
2019-07-01 |
description |
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° and 40° 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°. 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° (IQR: 27–33) and 36° (IQR: 33–38) in the Boston and Providence groups, respectively ( p < 0.001). At follow-up, 13 patients (35%) had progressed to ≥45° 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° 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° 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° 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. |
url |
https://doi.org/10.1177/2309499019860017 |
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