Bracing may prevent scoliosis surgery in adolescent girls and boys by delaying curvature progression, according to a recent study. Findings published in the New England Journal of Medicine revealed that a back brace treatment for teens with idiopathic scoliosis could even prevent spine surgery. Orthopedic surgeons from the United States and Canada observed 242 patients between the ages of 10 and 15 who were still growing and had a spinal curvature of 20 to 40 degrees.
A total of 116 patients were randomly assigned to observation or bracing for at least 18 hours daily to monitor the effectiveness of a back brace in preventing curvature progression. The researchers noted too few families agreed to randomization so the researchers added a group of 126 adolescents who chose for themselves between bracing and observation.
In the study, bracing would be considered ineffective if spinal curvature progressed to 50 degrees or more, which would suggest surgery is needed at this point. A back brace would be considered successful if the participant achieved skeletal maturity — when the bones and spine are finished growing — with a 50-plus degree curve progression.
The researchers stopped the trial early because of the high effective rate of bracing.
The results of the study showed that bracing treatment was a success in 72 percent of children, compared with 78 percent among those in the observation group. The researchers noted that the longer the participants wore the brace, the more benefit they saw in treating teen scoliosis. More than 90 percent of the children who were successfully treated wore their braces for more than 13 hours a day, the New York Times reports.
“There were a lot of doctors like me who treat scoliosis as the primary focus of their practice who had doubts about whether bracing was effective,” said Dr. Stuart L. Weinstein, lead author of the study and professor of orthopedic surgery at the University of Iowa, to the New York Times. “Now the jury is in."
"I won't be so much telling kids that I don't know whether it works," Dr. James Wright, study co-author and surgeon-in-chief at the Hospital for Sick Children in Toronto, told CBC News. "I'm going to be saying, it does work and I'm afraid you have to wear it."
Maddie Houser from North Liberty, Iowa was a participant in the study who chose to wear a brace. She underwent spine surgery 30 years ago to treat her scoliosis, leaving her in an upper-body cast for nine months. Thanks to the study, however, Maddie now has a spinal curvature holding steady at 28 degrees and has achieved skeletal maturity. She will no longer need bracing.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, three out of every 100 people have some form of scoliosis, with idiopathic scoliosis typically occurring after the age of 10 in children.