Article

The objective of the present study was to assess, at skeletal
maturity, the efficacy of non-operative treatment by isolated nighttime brace in
the prevention of progression of progressive idiopathic scoliosis of less than 25
degrees . HYPOTHESIS: Isolated nighttime brace treatment is effective in the
prevention of progression of mild progressive idiopathic scoliosis (Cobb<25 degrees ). METHODS: A single-center retrospective study included 142
patients managed by nighttime brace for progressive idiopathic scoliosis with
Cobb angle<25 degrees , with assessment at skeletal maturity. Mean Cobb angle at
start of treatment was 15.5 degrees (range, 10-25 degrees ). Mean values for Cobb
angle and sagittal parameters before treatment and at skeletal maturity were
compared on Student t-test. Change in Cobb angle over time was also analyzed.
RESULTS: Mean Cobb angle at skeletal maturity was 16.3 degrees , showing
significant increase over baseline (15.5 degrees ; P=0.04), although the
difference was less than the uncertainty of measurement (+/-6 degrees ). In
baseline Risser 0 or 1, mean change in Cobb angle at skeletal maturity (16.2
degrees ) was not significant (P=0.1). Cobb angle diminished in 26 cases (18%),
increased in 24 (17%) and was unchanged in 92 (65%). CONCLUSION: The present
study confirmed the efficacy of non-operative treatment by nighttime brace in
mild progressive idiopathic scoliosis (<25 degrees ) in a large majority of
cases. A nighttime brace thus seems to be an effective option for the treatment
of adolescent scoliosis, ensuring a safe curve of around 20 degrees . LEVEL OF
EVIDENCE: Level IV, retrospective study.
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Langue : FRANCAIS