Nighttime bracing with the Providence thoracolumbosacral orthosis for treatment of adolescent idiopathic scoliosis: A retrospective consecutive clinical series.

Abstract

BACKGROUND::

Orthotic treatment for adolescent idiopathic scoliosis is a mainstay in nonoperative treatment to prevent progressive spinal deformity.

OBJECTIVE::

To determine the effectiveness of the Providence orthosis in the treatment of adolescent idiopathic scoliosis.

STUDY DESIGN::

Retrospective review.

METHODS::

Patients treated with a Providence orthosis for adolescent idiopathic scoliosis were reviewed. Inclusion criteria included the following: age of 10-18 years; curve magnitude of 25°-40°; Risser stage of 0-2; and, if female, <1 year post menarche at the time of brace initiation. Failure was defined as curve magnitudes progressing >5° or to >45° or surgery. Radiographs and clinical information were recorded and compared between treatment success and failure cohorts.

RESULTS::

56 patients (51 female and 5 male; average of 12.26 years) were identified with average of 2.21-year follow-up and a 57.1% success rate for preventing curve progression. Factors associated with successful treatment included curve apex T10 and caudal and Risser sign ⩾ 1. Multivariate analysis identified Risser ⩾ 1 and curve apex T10 and caudal as independent predictors of successful treatment.

CONCLUSION::

The Providence nighttime orthosis can be an effective treatment for adolescent idiopathic scoliosis. Curve Apex at T10 or caudal was an independent predictors of treatment success.

CLINICAL RELEVANCE:

This study identifies variables associated with treatment success using the Providence nighttime orthosis in a consecutive series of adolescent idiopathic scoliosis patients. This information provides the foundation for identifying ideal patients for nighttime bracing to guide clinical treatment.

• Authors: Leigh Davis, Joshua S Murphy, Kenneth A Shaw, Kaitlin Cash, Dennis P Devito, Michael L Schmitz
• Journal: Prosthetics and orthotics international (Prosthet Orthot Int) Vol. 43 Issue 2 Pg. 158-162 (Apr 2019) ISSN: 1746-1553 [Electronic] France
• PMID: 30101680 (Publication Type: Journal Article)

Topics

• Adolescent
• Analysis of Variance
• Braces (statistics & numerical data)
• Child
• Circadian Rhythm
• Cohort Studies
• Equipment Design
• Female
• Humans
• Lumbar Vertebrae (physiopathology)
• Lumbosacral Region
• Male
• Orthotic Devices
• Patient Compliance (statistics & numerical data)
• Retrospective Studies
• Scoliosis (diagnosis, therapy)
• Thoracic Vertebrae (physiopathology)
• Treatment Outcome