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

Davis, Leigh; Murphy, Joshua; Shaw, K. Aaron; Cash, Kaitlin; Devito, Dennis P.; Schmitz, Michael L.

doi:10.1177/0309364618792727

Cited by 20 publications

(40 citation statements)

References 27 publications

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“…The results of the search; (1) 31 items have been found of which 14 were found to be relevant reporting a rate of success [7,9,47,52,55,[62][63][64][65][66][67][68][69][70]; (2) 14 items were found of which 3 reported upon cosmetic outcomes [71][72][73]. In the hand search additional papers were revealed for search (1) [32- 46, 48-51, 53-55, 74].…”

Section: Resultsmentioning

confidence: 99%

“…More symmetrical braces (Boston style) have consistent success rates of just over 70% [7,9,[32][33][34][35], whilst asymmetrical full-time braces show success rates between 50 and 95% [8,[36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Night-time braces when compared to full-time braces seem to have poor results (57.1%) [55]. Standardised asymmetrical braces may have success rates exceeding 80% [8,41,46] even in curves of 40° and above [47,74].…”

Section: Resultsmentioning

confidence: 99%

“…It is not the name of the brace that ensures a good outcome; it is the brace manufacture and adjustments based on standardised algorithms [76,77]. It is concerning that in many studies on brace treatment, an example of the brace design is not presented in a picture [55,78]; sometimes the brace design is not even named [78]. Brace Treatment for Children and Adolescents with Scoliosis DOI: http://dx.doi.org /10.5772/intechopen.91234 Outcomes with respect to Cobb angle: Landauer et al in their retrospective study [37] examined 62 adolescent female patients with right thoracic scoliosis Cobb degrees) treated with a Chêneau style brace.…”

Section: Discussionmentioning

confidence: 99%

“…Both studies indicate that less skeletally mature patients had worse outcomes than the more mature patients. This seems the typical finding in low quality braces that patients more at risk for progression have worse outcomes than the more mature lower-risk patients [55,70].…”

Section: Figure 6 X-ray Of a Patient With A Main Thoracic Curve To Tmentioning

confidence: 97%

“…Brace treatment is supported by high-quality evidence as well [7][8][9]; however, the approach to bracing differs significantly in design (Figure 1). There are many types such as symmetrical braces [7,9,[32][33][34][35], asymmetrical braces [8,[36][37][38][39][40][41][42][43][44][45][46][47][48][49], night-time braces [50][51][52][53][54][55] and soft braces [56,57]. It has been shown that soft braces have no advantage over hard braces [8,[58][59][60].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Brace Treatment for Children and Adolescents with Scoliosis

Weiss¹,

Turnbull²

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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The aim of brace treatment in patients with scoliosis during growth is (1) to stop curve progression and (2) to improve appearance/cosmesis. There is high quality evidence available supporting brace treatment. According to recent publications, the outcomes of different braces vary to a high extent. Although most of the scoliosis cases will not affect the patient's health, the impact of braces on the cosmetic outcome to date is not well determined. Standardised asymmetric braces (mainly Chêneau derivatives) have better outcomes than symmetric compression braces and may also lead to significant improvements of the deformity. For symmetric braces, no evidence exists that these could significantly change the deformity. Soft braces have no indication and the use of night-time braces should be largely restricted due to poor outcomes when compared to current standards of full-time bracing.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figure 6 X-ray Of a Patient With A Main Thoracic Curve To Tmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Brace Treatment for Children and Adolescents with Scoliosis

Weiss¹,

Turnbull²

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis

Charalampidis,

Diarbakerli,

Dufvenberg

et al. 2024

JAMA Netw Open

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ImportanceModerate-grade adolescent idiopathic scoliosis (AIS) may be treated with full-time bracing. For patients who reject full-time bracing, the effects of alternative, conservative interventions are unknown.ObjectiveTo determine whether self-mediated physical activity combined with either nighttime bracing (NB) or scoliosis-specific exercise (SSE) is superior to a control of physical activity alone (PA) in preventing Cobb angle progression in moderate-grade AIS.Design, Setting, and ParticipantsThe Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS) randomized clinical trial was conducted from January 10, 2013, through October 23, 2018, in 6 public hospitals across Sweden. Male and female children and adolescents aged 9 to 17 years with an AIS primary curve Cobb angle of 25° to 40°, apex T7 or caudal, and skeletal immaturity based on estimated remaining growth of at least 1 year were included in the study. Dates of analysis were from October 25, 2021, to January 28, 2023.InterventionsInterventions included self-mediated physical activity in combination with either NB or SSE or PA (control). Patients with treatment failure were given the option to transition to a full-time brace until skeletal maturity.Main Outcomes and MeasuresThe primary outcome was curve progression of 6° or less (treatment success) or curve progression of more than 6° (treatment failure) seen on 2 consecutive posteroanterior standing radiographs compared with the inclusion radiograph before skeletal maturity. A secondary outcome of curve progression was the number of patients undergoing surgery up until 2 years after the primary outcome.ResultsThe CONTRAIS study included 135 patients (45 in each of the 3 groups) with a mean (SD) age of 12.7 (1.4) years; 111 (82%) were female. Treatment success was seen in 34 of 45 patients (76%) in the NB group and in 24 of 45 patients (53%) in the PA group (odds ratio [OR], 2.7; 95% CI, 1.1-6.6). The number needed to treat to prevent curve progression with NB was 4.5 (95% CI, 2.4-33.5). Treatment success occurred in 26 of 45 patients (58%) in the SSE group (OR for SE vs PA, 1.2; 95% CI, 0.5-2.8). Up to 2 years after the primary outcome time point, 9 patients in each of the 3 groups underwent surgery.Conclusions and RelevanceIn this randomized clinical trial, treatment with NB prevented curve progression of more than 6° to a significantly higher extent than did PA, while SSE did not; in addition, allowing transition to full-time bracing after treatment failure resulted in similar surgical frequencies independent of initial treatment. These results suggest that NB may be an effective alternative intervention in patients rejecting full-time bracing.Trial RegistrationClinicalTrials.gov Identifier: NCT01761305

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Ist eine Verbesserung der Behandlungssicherheit in der Korsettversorgung von Skoliosepatienten durch Anwendung standardisierter CAD-Algorithmen möglich?

Weiss¹,

Lay²,

Seibel³

et al. 2020

Orthopäde

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Zusammenfassung Hintergrund Die Versorgung von Skoliosepatienten mit korrigierenden Rumpforthesen führt auch heutzutage noch zu recht unterschiedlichen Ergebnissen. Publizierte Erfolgsquoten zwischen 50 und 90 % führen zwangsläufig zu der Frage, wie sich die Erfolgsquoten der Korsettversorgung steigern und vereinheitlichen lassen. Die Ergebnisse einer mit dieser Zielsetzung weiterentwickelten computerunterstützen (CAD/„Computer Aided Design“) Chêneau-Versorgung werden dargestellt. Methodik Am Stichtag (08.12.2019) wurde die prospektiv angelegte Datenbank unserer Abteilung retrospektiv ausgewertet. Es waren ausschließlich unreife Mädchen mit einer Adoleszentenskoliose, Alter 10–14 Jahre, Risser 0–2 in die Datenbank aufgenommen worden. Ergebnisse Sowohl die Gesamtgruppe mit einem Beobachtungszeitraum von mindestens 18 Monaten als auch die Patientinnengruppen mit bereits erreichtem Behandlungsabschluss zeigten Erfolgsraten zwischen 86 und 88 %. Die Ergebnisse insgesamt waren signifikant besser als die Erfolgsrate der Boston-Brace-Kontrollgruppe (BRAIST) von 72 %. Auch im Vergleich mit den Ergebnissen anderer Chêneau-Derivate war die Erfolgsrate unserer Serie teils deutlich besser. Schlussfolgerungen Die Behandlungssicherheit für die Patienten mit Skoliosen sollte verbessert werden. Ein Ansatz hierzu kann die Verwendung standardisierter CAD-Bibliotheken sein. Weitere Untersuchungen mit Studiendesigns höherer Evidenz sind notwendig, um die in unserer Untersuchung gefundenen Ergebnisse zu untermauern.

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

Cited by 20 publications

References 27 publications

Brace Treatment for Children and Adolescents with Scoliosis

Brace Treatment for Children and Adolescents with Scoliosis

Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis

Ist eine Verbesserung der Behandlungssicherheit in der Korsettversorgung von Skoliosepatienten durch Anwendung standardisierter CAD-Algorithmen möglich?

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