Adolescent idiopathic scoliosis managed by a nighttime bending brace

Abstract

This study evaluated and compared the effectiveness of managing adolescent idiopathic scoliosis with a total contact bending spine orthosis worn only during nighttime sleep with established bracing programs and electrical stimulation treatment. Brace treatment was prescribed for 30 patients with adolescent idiopathic scoliosis for the management of 50 spinal curvatures averaging 28.5 degrees (range: 13 degrees-40 degrees). Average patient age at the initiation of brace wear was 12+/-10 years (range: 9+/-10 to 16+/-8 years). All 30 patients were skeletally immature (Risser sign, 0-3) at initiation of orthotic treatment and underwent follow-up to maturity. Patients were instructed to wear the braces for at least 8-10 hours a day during nighttime sleep. Eighteen of 30 patients were compliant with the bracing program. Compliance with the nighttime bending brace was no better than the reported compliance with established thoracolumbosacral orthosis programs. Moreover, noncompliant patients and those treated by the ineffective electrical stimulation program also did not differ in curve progression. Curve progression was controlled in 56% of the compliant patients, and the nighttime bending brace was considered as effective as the Wilmington brace in controlling adolescent idiopathic scoliosis. Both braces were more effective than the ineffective electrical stimulation treatment.