Historically, full-time bracing has been the most prominent and widely accepted method for the conservative management of scoliosis. Many design variations have been introduced over the years, with each one claiming to exceed the benefits of its predecessors. There’s no shortage of research comparing various iterations of full-time orthoses, yet very little evidence exists to demonstrate any significant and repeatable advantages of one design over all others. In general, the effectiveness of any orthosis relies on meeting a few principles and requirements: in-brace correction (reduction of Cobb and rotation); alignment and balance in the sagittal and coronal planes; and, of course, patient compliance. Combined, those criteria for success can create complicated scenarios when treating actual patients, especially those who are required to wear a brace for 18 to 22 hours per day. The challenges most often stem from the need for the patient to be upright and mobile. That alone contributes to most of the complications that result from traditional full-time brace design.
With nighttime bracing, most of those challenges do not exist. There are significant advantages to bracing at night, including simplified brace design, the ability to apply more targeted corrective forces, improved compliance, and potentially better outcomes.