DOS 2019

DOS Kongressen 2019 · 183 Conservative Treatment of Main Thoracic Adolescent Idiopathic Scoliosis: Full-time or Night- time bracing? Søren Ohrt-Nissen, Markus Lastikka, Thomas Borbjerg Andersen, Ilkka Helenius, Martin Gehrchen Department of Orthopaedic surgery, Spine Unit, Rigshospitalet; Department of Pediatric Orthopedic Surgery, Turku University Hospital Background: The full-time Boston brace is a well-established treatment in ad- olescent idiopathic scoliosis (AIS). The part-time Providence brace has become popular but some studies suggest that is not suitable for thoracic AIS. Purpose / Aim of Study: To compare treatment efficacy between the Boston full-time brace and the Providence part-time brace in main thoracic AIS. Materials and Methods: Patients were treated with either the Boston brace (n=37) or the Providence brace (n=40) at two different institutions. Inclusion criteria were Risser grade ≤2, major curve between 25-40° 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°. Findings / Results: Median age was 12.6 years and median treatment length at follow-up was 25 months (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 group, respectively (p<0.001). At follow-up, 13 patients (35%) had progressed to ≥45° in the Boston group vs. 16 patients (40%) in the Providence group (p = 0.838). Twenty-three pa- tients (62%) had progressed by more than five degrees in the Boston group vs. 22 patients (55%) in the Providence group (p=0.685). The secondary thoraco- lumbar/lumbar curve progressed by more than five degrees 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, pro- gression of more than 5 degrees or to surgical indication area was similar in the Boston group. Our results indicate that night-time bracing is a viable alternative to full-time bracing also in main thoracic AIS. 139.