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Nighttime Bracing: A New Hope for Adolescents with Idiopathic Scoliosis

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Anthony Raphael
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Nighttime Bracing: A New Hope for Adolescents with Idiopathic Scoliosis

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Adolescent idiopathic scoliosis (AIS) is a condition that affects many young people worldwide. This disease is characterized by a sideways curvature of the spine which usually happens just before puberty, during the growth spurt. The treatment options for AIS often involve wearing a brace full time, which can be a significant burden for adolescents. However, a recent study brings new hope for these young patients. According to the Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS) trial, wearing a brace at night, combined with self-managed physical activity, can be an effective alternative for AIS if the patient rejects wearing a brace full time. This article delves into the trial's findings and the potential benefits of nighttime bracing for adolescents with AIS.

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The CONTAIS Trial

The CONTAIS trial involved 135 patients aged 9-17 years and was published in JAMA Network Open. The results showed that a group using self-managed physical activity combined with nighttime bracing achieved better results in preventing Cobb angle progression in moderate-grade AIS than self-managed physical activity alone or scoliosis-specific exercise. An important factor to note was the number of hours the brace was worn, which significantly affected the treatment's success. However, physicians were advised to consider the sensitivities of youth and the effect on their self-esteem when prescribing bracing, as many adolescents may have a fear of ridicule.

Charleston Nighttime Brace

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The Charleston nighttime brace is a common choice for nighttime bracing. Courtesy of C. Ralph Hooper, Jr., CPO, Charleston Bending Brace Foundation, this brace relies on side-bending for curve correction. The convenient design allows patients to only wear it during sleep, reducing the impact on their daily activities and potentially enhancing their comfort and compliance.

Patients' Experience and Attitude Towards AIS

Another study, which involved a qualitative cross-sectional approach, shed light on the long-term experience and attitudes of patients who were operated on for AIS more than 25 years ago with CD instrumentation. Despite concerns about self-image, low back pain, and lack of spinal flexibility, the majority of patients were satisfied with the treatment received. This study emphasizes the importance of considering the patients' perspective in treatment planning and the need to address their concerns effectively.

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Advancements in Night Bracing Technology

Recent advancements in night bracing technology have made it a more viable option for AIS treatment. A webpage from the Scottish Rite for Children discusses the effectiveness of night bracing in preventing progression of the condition and the potential benefits for patients. It also covers the latest research and advancements in night bracing technology for AIS scoliosis, highlighting its promising future in the field of scoliosis treatment.

In conclusion, the introduction of nighttime bracing as an alternative treatment for AIS offers a glimmer of hope for young patients struggling with the condition. While the approach requires further research, the initial results are promising and signify a potentially important shift in the management of AIS. As the medical community continues to strive for better treatment strategies, the focus should always be on the holistic well-being of the patients, considering not only their physical health but also their psychological and emotional well-being.

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