Vojtech Capek: Brace treatment for adolescent idiopathic scoliosis (AIS) can be individualized
The overall aim of Vojtech Capek’s thesis is to contribute to increased knowledge that may enable a more individualized and appropriate treatment strategy for young people with AIS. The results highlight the complex interplay of patient-related factors that influence both the risk of scoliosis progression and treatment outcomes.
VOJTECH CAPEK
Dissertation defense: 29 May 2026 (click for details)
Doctoral thesis: Individualizing brace treatment for adolescent idiopathic scoliosis: Skeletal maturity, bracing strategies and prognostic modeling
Research area: Orthopaedics
Sahlgrenska Academy, The Institute of Clinical Sciences
Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately one in thirty otherwise healthy children. About one in ten requires treatment with a plastic brace to prevent the curvature from worsening during growth. The brace is usually intended to be worn for most of the day over several years, which can represent a significant burden for the individual.
"Severe scoliosis often requires later surgery involving correction and spinal fusion of multiple vertebrae. But effective brace treatment can slow the progression and is therefore of great importance," says Vojtech Capek, senior consultant at the spine and tumor section, Department of Orthopedics at Sahlgrenska University Hospital, and doctoral student at the Institute of Clinical Sciences.
Full-time brace or nighttime brace
"In the first part of the thesis, we compared the treatment effects of the two most common braces used in Sweden: the Boston full-time brace and the Providence nighttime brace."
Nighttime bracing was developed to reduce the burden of wearing a full-time brace during adolescence. The aim has been to achieve similar correction of scoliosis using only nighttime treatment. However, the extent to which this approach can replace full-time treatment, or which patient groups may benefit most from nighttime bracing, has not been sufficiently studied.
"The results of the thesis show that full-time bracing is more effective than nighttime bracing for patients with AIS. However, nighttime bracing may still be an appropriate option for patients with more advanced skeletal maturity, particularly in cases of lumbar scoliosis."
"Finally, we developed a web-based calculator that can help physicians choose between nighttime and full-time treatment for a child based on their unique risk profile."
Skeletal age – an important factor for treatment outcomes
In the second part, the focus was on skeletal age, a factor with a major impact on treatment outcomes.
"We developed a new classification for skeletal age - Pelvic Maturity Indicators (PMI) - which expands on an earlier classification based on pelvic radiographs, and we compared it with a classification based on hand radiographs."
The results show that PMI provides a better opportunity to assess biological age at earlier stages than the previous classification. In addition, good agreement was found with hand radiograph assessments, which is important for both future research and clinical practice.
"The nighttime brace calculator, which is based on predictive analysis, will hopefully also contribute to more accurate identification of which adolescents are suitable for nighttime versus full-time brace treatment."
What has been most rewarding and challenging about the doctoral project?
"The entire research process has been very rewarding, especially because these questions frequently arise in our clinical practice. It is gratifying that we can now answer at least some of them and better refine brace treatment, which may ultimately reduce the burden on children," says Vojtech Capek, and continues:
“There was something almost magical about watching new results emerge from uncertainty. At the same time, developing a new classification system proved challenging, requiring an unusual but fascinating methodological approach”.
Text: Susanne Lj Westergren