Treating Adolescent Scoliosis

  There are many mixed opinions about whether braces are helpful in treating scoliosis. Some conservative treatment methods still advertise in their advertising that "no braces" are necessary or that braces are outdated or even harmful. Many orthopedic surgeons seem to have little faith in the ability of braces to help and may recommend them with "fingers crossed" "we'll get lucky". Still, some specialists insist that scoliosis patients should wear a brace 23 hours a day. Who is right? How can you determine who gives you the best advice? What would be helpful to answer this question is a mega study comparing the outcomes of patients who wear a brace to patients with scoliosis who DO NOT wear a brace. That's exactly what the publishers of the "BRAIST" (Bracing in Adolescent Idiopathic Scoliosis Trial) set out to do - and they did1. The results of this study may scare you. The very first sentence of the BRAIST study states: "The role of orthosis in patients with adolescent idiopathic scoliosis who are at risk for curve progression and possible surgery is controversial". This is why the study was done. To target those "at risk of curve progression," the study targeted growing. Such a group is known to be at high risk of progression above 50 degrees. A "successful" outcome was defined as follows: The curve remained below 50 degrees of size when the child finished growing. A failed outcome was defined as: "Any child who progressed beyond 50 degrees. This threshold was chosen because curve progression into adulthood is likely when the Cobb angle has increased so during adolescence. This is the point at which most surgeons recommend operation. By dividing these children into two groups - those who received a brace and those who did not - the study . It is also important to note that only rigid braces were allowed in this study. Soft braces did not qualify. The shocking result of the study is this: Wearing the brace had so much greater success than not wearing . The study had to be stopped far ahead of schedule because the results were so obvious: Refusing rigid! Two solid conclusions and one shocking number emerged from the BRAIST study. In the watch and wait observation group there was a 58% FAILURE RATE What is this shocking number? Fifty-eight percent of the non-braced "observation only" group required surgery, with deterioration beyond." Fifty-eight percent are huge—that's more than half of the kids in the 20-40 degree range who are still growing and ended up needing surgery! This number was before reported as only 22%2, the BRAIST authors predicted as high as 30%, but no one even realized! This is a massive failure in the current "Observation - Wait and See" standard of care in the management of scoliosis! One would think that such solid findings in favor of rigid bracing would send shock waves throughout. Controversy is dead... isn't it? What is left to debate? Shouldn't everyone recommend fixed braces? It has been almost 5 years since the publication of the BRAIST study, but unfortunately. Whatever the reason, the confusion that anti-braces messages bring to the public. Don't let your child fall victim to misinformation. Read about the BRAIST trial and you'll find that the jury is out on fixed braces, and that's remarkable, especially when patients actually. A final note on the BRAIST study: Although we know that wearing a brace for more than 18 hours a day produces better results, the study did not provide data. , the straighter the brace can hold the spine, the greater the chance that the spine will grow straight. Research is emerging to suggest that focusing on developing braces that provide better.