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Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?
Ohrt-Nissen, Søren; Lastikka, Markus; Andersen, Thomas Borbjerg; Helenius, Ilkka; Gehrchen, Martin.
Afiliación
  • Ohrt-Nissen S; 1 Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Lastikka M; 2 Department of Pediatric Orthopedic Surgery, Turku University Hospital, Turku, Finland.
  • Andersen TB; 1 Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Helenius I; 2 Department of Pediatric Orthopedic Surgery, Turku University Hospital, Turku, Finland.
  • Gehrchen M; 1 Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
J Orthop Surg (Hong Kong) ; 27(2): 2309499019860017, 2019.
Article en En | MEDLINE | ID: mdl-31284817
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Escoliosis / Vértebras Torácicas / Tirantes / Tratamiento Conservador Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Orthop Surg (Hong Kong) Asunto de la revista: ORTOPEDIA Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Escoliosis / Vértebras Torácicas / Tirantes / Tratamiento Conservador Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Orthop Surg (Hong Kong) Asunto de la revista: ORTOPEDIA Año: 2019 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido