Other Treatments for Scoliosis—Braces or Casts
by Rosalyn Carson-DeWitt, MD
Use of bracing for scoliosis depends on the child's age and nature of the scoliosis. It does not work with every child, especially infants, and evidence is limited about its effectiveness. A brace is generally recommended for scoliosis curves that are greater than 20°-25° and less than 40º-50°, or that have progressed by more than 10°, and only if your child is still growing. Braces are worn in an effort to stop the spine from progressing to greater degrees of curvature. While they will not improve the current degree of scoliosis, they may prevent progression that could lead to a need for surgery.
Your child will be asked to wear the brace for 16 to 23 hours a day, and will be given special exercises to maintain lung function.
Bracing may not be helpful in girls who have had their period for more than a year, in children who have attained full growth, or are within one year of full pelvic bone growth. At this point, it’s thought that the degree of scoliosis will be stable. If the degree of scoliosis continues to progress despite the brace, surgery may be advised if the curvature reaches approximately 40° to 50°.
It can be awkward to wear these braces. They are uncomfortable and hot, and many adolescents feel embarrassed about appearing so different. If your child has difficulty adjusting to the brace, talk to the doctor about how they can build up tolerance for it.
Types of braces include:
This brace covers the entire torso. It has an area to rest the chin and a headrest for the back of the head. One flat bar travels down the front, and two flat bars travel down the back. This type of brace is used for scoliosis occurring at any point along the spine.
Thoracolumbosacral Orthosis (TLSO) or Boston Brace
This brace is a bit less chunky and noticeable than the Milwaukee brace. It does not extend up under the chin or behind the head. Instead, it stays under the arms and wraps around the back, rib cage, lower back, and hips.
Charleston Bending Brace
This is a brace that is worn only at night. Questions remain about its effectiveness.
Researchers are still looking into this new type of brace that consists of a cotton vest and adjustable bands. Its effectiveness is still being evaluated.
A treatment called serial casting may be an option for some infants and children. It involves applying the cast around the chest and abdomen and changing it every 3-6 months. Doing so immobilizes the trunk, which may straighten the spine. Casting is done with anesthesia. This helps your child's spine relax so the doctor can reposition it before the cast is applied. If your child's spine still needs treatment, serial casting can delay surgery until a later age.
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Last reviewed May 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 5/16/2017
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