J Seifert1, A Selle. 1. Wirbelsäulenbereich, Klinik für Orthopädie, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Deutschland. Jens.Seifert@Uniklinikum-Dresden.de
Abstract
BACKGROUND: The aim of our investigation was to evaluate the effectiveness of isolated night-time treatment in idiopathic scoliosis. METHODS: Twenty-two children (average age 11.9 years; range 5-12 years) underwent treatment with the "Dresdner night-time brace." We indicated brace treatment in all children with a Cobb angle of 20-25 degrees and also in those with an angle of 15-19 degrees in cases of progression. Over a follow-up period of 25 months, clinical and radiological observations were made. RESULTS: A primary correction of 82.2% was obtained. The mean Cobb angle in an upright position without orthosis before treatment was 20.2 degrees. At the end of treatment, this angle reached 15.8 degrees. Operations were able to be avoided completely. In only three cases with radiographic progression (development of angles >25 degrees), part-time bracing had to be stopped and changed to full-time bracing. We observed an overall success rate of 86.4% (patients with improved Cobb angles or halted progression). CONCLUSION: We were able to show a positive effect of part-time bracing in selected patients with mild scoliosis and a higher risk of progression. The negative medical and psychosocial consequences of 23-h brace treatment can therefore be avoided in certain patients.
BACKGROUND: The aim of our investigation was to evaluate the effectiveness of isolated night-time treatment in idiopathic scoliosis. METHODS: Twenty-two children (average age 11.9 years; range 5-12 years) underwent treatment with the "Dresdner night-time brace." We indicated brace treatment in all children with a Cobb angle of 20-25 degrees and also in those with an angle of 15-19 degrees in cases of progression. Over a follow-up period of 25 months, clinical and radiological observations were made. RESULTS: A primary correction of 82.2% was obtained. The mean Cobb angle in an upright position without orthosis before treatment was 20.2 degrees. At the end of treatment, this angle reached 15.8 degrees. Operations were able to be avoided completely. In only three cases with radiographic progression (development of angles >25 degrees), part-time bracing had to be stopped and changed to full-time bracing. We observed an overall success rate of 86.4% (patients with improved Cobb angles or halted progression). CONCLUSION: We were able to show a positive effect of part-time bracing in selected patients with mild scoliosis and a higher risk of progression. The negative medical and psychosocial consequences of 23-h brace treatment can therefore be avoided in certain patients.