Evaluation of night-time bracing efficacy in the treatment of adolescent idiopathic scoliosis: a systematic review
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REVIEW ARTICLE
Evaluation of night‑time bracing efficacy in the treatment of adolescent idiopathic scoliosis: a systematic review Alberto Ruffilli1 · Michele Fiore1 · Francesca Barile1 · Stefano Pasini1 · Cesare Faldini1 Received: 6 June 2020 / Accepted: 3 November 2020 © Scoliosis Research Society 2020
Abstract Study design Systematic review of the literature. Purpose To systematically review the literature to assess the efficacy of night-time bracing in controlling curve progression with respect to traditional full-time thoraco-lumbo-sacral orthoses (TLSOs) in patient with adolescent idiopathic scoliosis. Methods PubMed, Ovid, Cochrane Reviews and Google Scholar were all accessed and a combination of terms and keywords pertaining to the core concept was used in the research. Case reports, technical notes, instructional courses, literature reviews, biomechanical and/or in vitro studies were all excluded, as well as case series (level IV studies). The methodological quality of the selected articles was assessed using the MINORS methodology score. Given the overall level and quality of the available evidence, conclusions were drawn based on a summary of the evidence. Results Seven studies were included. Five papers reported no differences in curve progression between traditional TLSOs and night-time braces and the remaining two studies reported TLSO to be superior. Conclusion The current available literature does not permit us to draw conclusions about night-time braces. The low methodological quality of the studies examined makes it impossible to compare the effectiveness of the night-time braces with that of traditional TLSOs. Prospective well-designed clinical trials applying SRS inclusion and evaluation criteria are mandatory to better define the role of night-time orthosis in the treatment of adolescent idiopathic scoliosis. Keywords AIS · Scoliosis · Night-time bracing · Charleston brace · Providence brace · Scoliosis progression · Bracing efficacy
Introduction Adolescent idiopathic scoliosis (AIS) is a complex threedimensional deformity of the spine and ribs. The accepted threshold of the current literature to surgically treat a scoliosis ranges between 45° and 50° Cobb angle. In curves with Cobb values ranging from 20° to 45°, conservative treatment by thoraco-lumbo-sacral orthosis (TLSOs) is advised. There are many different brace designs, but the objective of all of them is to improve spine contour and alignment by applying external forces—together with the stimulation * Michele Fiore [email protected] 1
Department of Biomedical and Neuromotor Science‑DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy
of active correction—as the patient moves away from pressure within the brace [1]. Bracing significantly decreases the likelihood that high-risk curves will require surgery; the length of brace wear is inversely proportional to the likelihood that surgery will be required [2–4]. Howev
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