En Español
Home About Us Appointments Insurance Guide Location & Map Contact Us
How Can We Help You? Meet Our Medical Staff Electrodiagnostics Scoliosis and Spine Deformity Center Patient Information Library Work Comp Services International Patients Frequently Asked Questions

Scoliosis & Spine Deformity Center

Bracing

How Does Bracing Help Scoliosis?

Brace treatment is used for a child who is still growing to prevent progression of spinal curves that are between 25 and 40 degrees. Some doctors may use brace treatment for curves up to 45 degrees. Brace treatment is usually continued until the child's skeleton stops growing.

Two common types of braces include:

 

•Milwaukee brace, which consists of a customized pelvic girdle and a metal structure that extends to the neck. This brace is not hidden by clothing. The Milwaukee brace is used to treat curves high in the upper back, such as kyphosis (hunchback). The brace treatment of kyphosis in the upper back can often result in correction.

 

•Thoracolumbosacral orthosis (TLSO) Boston Brace, which is a brace that consists of a trunk and pelvic girdle that is customized to fit the child. It is used to treat curves in the mid back and lower back. This brace does not have a metal structure and can be hidden by clothing better than the Milwaukee brace. Braces are not effective for curves greater than 45 degrees.

 

Does Bracing Work?  Which Brace is the Best?

Braces are generally effective in providing immediate control of curves. When a brace is first applied, a significant correction is often seen. However, once the child stops wearing the brace, the curve usually returns. The Milwaukee brace is effective in preventing further progression of spinal curves. However, children often do not wear the brace as prescribed because it has to be worn nearly all the time-often 23 hours a day-and because the child may be embarrassed by how it looks.

The decision about which brace to wear depends on the type of curve and whether the patient will follow the doctor's directions about how many hours a day to wear the brace.

The TLSO "Boston Brace" is now most commonly used because it is effective in preventing a spinal curve from getting worse, and it is easier to use because it can be worn under clothing. Although bracing does not always prevent a spinal curve from getting worse, the best results occur when:

  • Bracing is started early, while the child is still growing.
  • The spinal curve is between 25 and 40 degrees. Some doctors may use brace treatment for curves up to 45 degrees.
  • The brace is well fitted.
  • The child wears the brace for the prescribed amount of time.
  • There is family support for the child.

Risks

Complications of bracing therapy include:

  • A child not wearing a brace for the prescribed amount of time, which allows the curve to get worse.
  • Skin irritation.
  • Discomfort.

What to Think About

Children who wear braces are examined by Dr. Francis regularly (such as every 3 months or 6 months or more frequently if problems arise) to monitor the effects of the brace. A child who has a severe forward curve in his or her upper back in addition to scoliosis may not be well suited for bracing.

Exercise and Sports

Children can ride a bicycle, play tennis, run, and jump while wearing a brace. However, they should not participate in activities such as horseback riding, skiing, skating, and gymnastics while wearing a brace. Because wearing a brace makes many physical activities difficult, children or teens are generally advised to remove their brace when they participate in activities such as physical education classes.

Fashion

Fashion can be a challenge for teens wearing a brace to correct scoliosis.  Click here to view “Fashion Rescue” a brochure for teenage girls created by resourceful teen, 16-year old Moira Lyons.  

References

  • Colles, DK; Ponseti, IV. (1969) Journal of Bone & Joint Surgery 51A, 425-445
  • Everett CR, Patel RK. A systematic literature review of nonsurgical treatment in adult scoliosis.
    Spine. 2007;32(19 Suppl):S130-134.
  • McMaster, MJ. Management of Scoliosis. J R Soc Med. 1982;75(9):685-688. [PubMed]
  • Nilsonne, U; Lundgren, KD. Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand.
    1968;39(4):456-465. [PubMed]
  • Roach JW (1999). Adolescent idiopathic scoliosis. Orthopedic Clinics of North America, 30(3):
    353–394.
  • Walker, KA. Facts and Tips About Scoliosis.2009. [www.SpineUniverse.com]

 
"));