Scoliosis - Braces

Highlights	Symptoms	Surgery
Introduction	Diagnosis	Treatment for Adult Scoliosis
Causes	Treatment	Resources
Risk Factors	Managing Scoliosis	References
Prognosis	Braces

Braces

A brace is often used to prevent further progression of moderate curves of (24 to 40 degrees). It is important to note that a brace will almost never reverse an existing curve and is only used to stop progression. One study reported overall success rates of around 74%, but results vary widely depending on the length of time the brace is worn, the type of brace, and the severity of the curve. The great majority of subjects in any scoliosis study are girls. Limited data suggest that in boys compliance rates are low and braces are not effective at all.

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Compliance with wearing a brace correlates strongly with success rate. In analysis of 34 patients, the compliance rate for the patients whose curve progressed by more than 5 degrees was 62%, while the compliance rate for the patients who did not progress was 85%.

It should be noted that in overweight patients with adolescent idiopathic scoliosis, braces appear to be less effective than in those who are not overweight. In one 10-year multicenter retrospective study, overweight patients were about 3 times more likely to have an unsuccessful result with braces than were those of normal weight.

One type of treatment for scoliosis is the use of a brace. The brace works by exerting pressure on the back and ribs to push the spine in a straighter position. The brace usually fits snugly around the torso and can come in many styles. In a child who is still growing, bracing is usually recommended to help slow the progression of the curve. The brace is usually worn full-time until the growth of the bones has stopped.

Many experts have questioned whether a brace is any better than nature in halting curvature progress in any patients. Early studies found that braces were successful in halting progression in only half of cases (the same rate as no treatment at all). In recent years, however, braces have improved. Many now fit under the arms and can be worn under the clothes, so that patients are much more likely to use them for longer periods during the day, which greatly affects their success rates.

Team Approach

Wearing the brace for the prescribed time is difficult but is essential for any success. A team approach, with several health professionals involved, is beneficial and often necessary to support the patient through the bracing process. An orthopedic surgeon interprets the x-rays, assesses the potential progression of the scoliosis, and plans the treatment with the patient and family. If a brace is used, an orthotist measures and fits the patient with the device. A physical therapist tailors an exercise program best suited for the patient. A nurse may also get involved to coordinate the treatment plans and provide physical and emotional support.