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

Abstract

Orthotic treatment for adolescent idiopathic scoliosis is a mainstay in nonoperative treatment to prevent progressive spinal deformity. To determine the effectiveness of the Providence orthosis in the treatment of adolescent idiopathic scoliosis. Retrospective review. 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. 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. 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. 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.