Flexibility Predicts Curve Progression in Providence Nighttime Bracing of Patients With Adolescent Idiopathic Scoliosis

Ohrt-Nissen, Søren; Hallager, Dennis Winge; Gehrchen, Martin; Dahl, Benny

doi:10.1097/brs.0000000000001634

Cited by 33 publications

(60 citation statements)

References 30 publications

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“…A subset of this population has previously been described. 8 The Boston brace is a prefabricated brace that works by applying compression to the convex side of the curve through pads placed at the apex Table 1. Overview of studies reporting on the efficacy of full-time and nighttime bracing in AIS patients.…”

Section: Methodsmentioning

confidence: 99%

“…A subset of this population has previously been described. 8 The Boston brace is a prefabricated brace that works by applying compression to the convex side of the curve through pads placed at the apex of the curve and below 20 (Figure 1). The Providence brace is custom-made, typically using CAD-CAM modeling, and works by applying compressive and rotational forces to the spine.…”

Section: Methodsmentioning

confidence: 99%

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Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Ohrt-Nissen

Lastikka

Andersen

et al. 2019

J Orthop Surg (Hong Kong)

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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.

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Section: Methodsmentioning

confidence: 99%

“…A subset of this population has previously been described. 8 The Boston brace is a prefabricated brace that works by applying compression to the convex side of the curve through pads placed at the apex of the curve and below 20 (Figure 1). The Providence brace is custom-made, typically using CAD-CAM modeling, and works by applying compressive and rotational forces to the spine.…”

Section: Methodsmentioning

confidence: 99%

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Ohrt-Nissen

Lastikka

Andersen

et al. 2019

J Orthop Surg (Hong Kong)

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“…Although a commonly used orthosis, there is limited and conflicting literature regarding the efficacy and indications for the Providence TLSO. 9–15…”

Section: Introductionmentioning

confidence: 99%

“…Although a commonly used orthosis, there is limited and conflicting literature regarding the efficacy and indications for the Providence TLSO. [9][10][11][12][13][14][15] The purpose of this study is to determine the effectiveness of the Providence TLSO in the treatment of AIS. We hypothesized that the Providence TLSO would be effective at altering the natural history of scoliosis.…”

mentioning

confidence: 99%

Nighttime bracing with the Providence thoracolumbosacral orthosis for treatment of adolescent idiopathic scoliosis

Davis

Murphy

Shaw

et al. 2019

Prosthetics &Amp; Orthotics International

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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.

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“…Kuroki et al proposed standing with traction position to assess spinal flexibility and predict orthotic correction [ 11 ], but its correlation with the in-orthosis correction was diverse due to varying maturity status of their patients (at 9–18 years with Risser 0–5). A recent study reported that the curve angle in the supine with lateral bending position was the same as the initial in-orthosis correction with a mean difference of 0.28° [ 12 ]. However, this finding may only be applicable to the Providence nighttime orthosis which was used in their study.…”

Section: Introductionmentioning

confidence: 99%

An effective assessment method of spinal flexibility to predict the initial in-orthosis correction on the patients with adolescent idiopathic scoliosis (AIS)

Cheung

et al. 2017

PLoS ONE

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BackgroundSpinal flexibility is an essential parameter for clinical decision making on the patients with adolescent idiopathic scoliosis (AIS). Various methods are proposed to assess spinal flexibility, but which assessment method is more effective to predict the effect of orthotic treatment is unclear.ObjectiveTo investigate an effective assessment method of spinal flexibility to predict the initial in-orthosis correction, among the supine, prone, sitting with lateral bending and prone with lateral bending positions.MethodsThirty-five patients with AIS (mean Cobb angle: 28° ± 7°; mean age: 12 ± 2 years; Risser sign: 0–2) were recruited. Before orthosis fitting, spinal flexibility was assessed by an ultrasound system in 4 positions (apart from standing) including supine, prone, sitting with lateral bending and prone with lateral bending. After orthosis fitting, the initial in-orthosis correction was routinely assessed by whole spine standing radiograph. Comparisons and correlation analyses were performed between the spinal flexibility in the 4 positions and the initial in-orthosis correction.ResultsThe mean in-orthosis correction was 41% while the mean curve correction (spinal flexibility) in the 4 studied positions were 40% (supine), 42% (prone), 127% (prone with lateral bending) and 143% (sitting with lateral bending). The correlation coefficients between initial in-orthosis correction and curve correction (spinal flexibility) in the 4 studied positions were r = 0.66 (supine), r = 0.75 (prone), r = 0.03 (prone with lateral bending) and r = 0.04 (sitting with lateral bending).ConclusionsThe spinal flexibility in the prone position is the closest to and most correlated with the initial in-orthosis correction among the 4 studied positions. Thus, the prone position could be an effective method to predict the initial effect of orthotic treatment on the patients with AIS.

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Flexibility Predicts Curve Progression in Providence Nighttime Bracing of Patients With Adolescent Idiopathic Scoliosis

Abstract: 3.

Cited by 33 publications

References 30 publications

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Nighttime bracing with the Providence thoracolumbosacral orthosis for treatment of adolescent idiopathic scoliosis

An effective assessment method of spinal flexibility to predict the initial in-orthosis correction on the patients with adolescent idiopathic scoliosis (AIS)

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