Study Proves Adolescent Scoliosis Bracing is Effective
A study published in the New England Journal of Medicine last week confirms what we in the orthotic community have long suspected, that bracing for Adolescent Idiopathic Scoliosis (AIS) is a successful method of treatment. The primary analysis of the study showed patients who were braced had a 75% success rate, while those who weren’t braced had just a 42% success rate. This was deemed significant enough to stop the study before completion, as ethically they could not continue with the randomized unbraced group.
Bracing for scoliosis began in the 16th century, utilizing metal bars and traction devices. Since then, technological advances have made it possible to fabricate a brace out of a strong plastic that is thin enough to be worn under clothing. Most physicians prescribe bracing for AIS patients that have curves of over 25 degrees, but under 50 degrees. There several different styles of braces, and some that can be worn all day or only at night.
This study included patients from all over the US and Canada, from 25 different orthotic sites, and let the practitioner use the style of brace that was deemed appropriate for the patient. Success with bracing is determined not by the amount the curve was lessened, but by slowing the curve from progressing. This study characterized success by the patient reaching skeletal maturity before the curve advanced to 50 degrees.
A key factor in scoliosis bracing is not only putting the brace on, but the length of time the brace is worn. Each brace was fabricated with a temperature sensor. When the temperature read 82 degrees or higher, the patient was wearing the brace. So the evaluators could not only tell if the brace was being worn, but for how many hours a day. The data showed that a scoliosis brace must be worn AT LEAST 13 hours a day, as those patients had success rates over 90%.
AIS has long been difficult to treat, and the data has been suggestive, but not conclusive in respect to bracing. This study not only states that scoliosis bracing is effective, but that we may be doing our children a disservice by not considering it an option.