LEIPZIG — Traditionally, idiopathic adolescent scoliosis (IAS) is
treated with full-time bracing which can have compliance problems. Researchers
here concluded that early night-time bracing is a sufficient replacement for
this method that can even lead to a suspension in bracing in well-controlled
Andreas Selle, of Orthopädie & Rehatechnik in Dresden, and a
colleague set out to find an alternative to the gold standard of full-time
bracing due to poor compliance among their patient population.
“My suggestion is to change,” Selle said during a presentation
to the 13th ISPO World Congress, here. “But before anyone changes his or
her standards, everyone wants to see results.”
Selle studied a group of 20 patients and found that early night-time
bracing with a 16· to 20· COBB angle can stop IAS progression and
negate the need for full-time bracing.
Additionally, he reported a correction of 90.9% for primary curves and
77% for secondary curves, which he noted was measured with the patient lying
down and suggested “true correction” be measured in an upright
position without the brace after a specified treatment period. After an average
of 5 years, Selle reported a true correction of 24.4% for primary curves and
12.2% for secondary curves.
Using this new methodology, Selle found a 92% compliance rate compared
to the 60% with the traditional method. Anecdotally, 98% of patients and their
parents preferred the new methodology.
“It’s an ideal controllable first step of treatment with low
risk of overtreatment,” Selle said.