%0 Journal Article
%T The effect of Providence night-time bracing on the sagittal profile in adolescent idiopathic scoliosis.
%A Heegaard M
%A Tøndevold N
%A Dahl B
%A Andersen TB
%A Gehrchen M
%A Ohrt-Nissen S
%J Eur Spine J
%V 33
%N 4
%D 2024 Apr 2
%M 38430401
%F 2.721
%R 10.1007/s00586-024-08186-w
%X <B>OBJECTIVE: </B>Adolescent idiopathic scoliosis (AIS) is characterized by coronal scoliosis and often a sagittal hypokyphosis. The effect of bracing on the sagittal profile is not well understood. The aim of this study is to assess the effect of night-time bracing on the sagittal profile in patients with AIS.<BR><B>METHODS: </B>We retrospectively included AIS patients with a main curve of 25-45° treated with a night-time brace in our institution between 2005 and 2018. Patients with estimated growth potential based on either Risser stage, hand X-rays, or menarchal status were included. Coronal and sagittal radiographic parameters were recorded at both brace- initiation and -termination. Patients were followed until surgery or one year after brace termination. Results were compared to a published cohort of full-time braced patients.<BR><B>RESULTS: </B>One hundred forty-six patients were included. Maximum thoracic kyphosis (TK) increased 2.5° (± 9.7) (p = 0.003), corresponding to a 3.5-fold relative risk increase post bracing in TK compared to a full-time brace cohort. Twenty-seven percent (n = 36) of the patients were hypokyphotic (T4/T12 < 20°) at brace initiation compared with 19% (n = 26) at brace termination (p = 0.134). All other sagittal parameters remained the same at follow-up. We found no association between progression in the coronal plane and change in sagittal parameters.<BR><B>CONCLUSIONS: </B>This is the first study to indicate that night-time bracing of AIS does not induce hypokyphosis. We found a small increase in TK, with a substantially lower risk of developing flat back deformity compared to full-time bracing. The coronal curve progression was not coupled to a change in TK.