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Outcomes for nighttime bracing in adolescent idiopathic scoliosis based on brace wear adherence

Spine deformity(2024)

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Abstract
Background This study determined brace wear adherence for patients treated with nighttime braces and evaluated the effect of brace adherence on curve progression. Methods One hundred twenty-two patients with AIS ages 10-16 years, Risser stages 0-2, major curves 20 degrees-40 degrees treated with Providence nighttime braces prescribed to be worn at least 8 h per night were prospectively enrolled and followed until skeletal maturity or surgery. Brace adherence was measured using iButton temperature sensors after 3 months of brace initiation and at brace discharge. Results Curve types were single thoracolumbar/lumbar (62%, n = 76), double (36%, n = 44), and single thoracic (2%, n = 2). Brace adherence averaged 7.8 +/- 2.3 h after 3 months (98% adherence) and 6.7 +/- 2.6 h at brace discharge (84% adherence). Curves that progressed >= 6 degrees had decreased brace adherence than non-progressive curves after 3 months (7.0 h vs. 8.1 h, p = 0.010) and at brace discharge (5.9 h vs. 7.1 h, p = 0.017). Multivariate logistic regression analysis showed that increased hours of brace wear [odds ratio (OR) 1.23, 95% confidence interval (CI) 1.06-1.46], single curves (OR 3.11, 95% CI 1.35-7.53), and curves < 25 degrees (OR 2.61, 95% CI 1.12-6.44) were associated with non-progression at brace discharge. Conclusions Patients treated with nighttime bracing have a high rate of brace adherence. Lack of curve progression is associated with increased brace wear. Nighttime bracing is effective at limiting curve progression in AIS single thoracolumbar/lumbar and double curves.
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Key words
Spine deformity,Providence,Compliance,AIS,TLSO,Curve
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