Bracing is part of what we call the conservative treatment for scoliosis and is the main non-surgical intervention in the treatment of idiopathic scoliosis, hyperkyphosis (Scheuermann disease) and occasionally for spondylolisthesis. It is indicated by your Doctor and carried out by an Orthotist (CPO) generally when you are in a growing period and you have been diagnosed with moderate scoliosis with the aim of preventing the curve progressing. On occasion, it can also be used in adult scoliosis or in the elderly, when pathological curves lead to a forward leaning posture or in adults, after traumatic injuries.
Bracing can be defined as the application of external corrective forces to the trunk where rigid supports or elastic bands can be used. You can find a custom-made brace or a prefabricated brace to use.
Furthermore, there are many types of braces that you can be offered to use for scoliosis; nevertheless, the type of brace selection will be a decision to make between the Expert, the patient and the family . Probably you will be asking why they are so many types of them. It’s because Orthotists are looking for a better way of treating scoliosis creating new brace designs in search for the most effective brace. We believe it is important to educate the patient and the family in order to pick the right decision for you, therefore, here you will find a brief description of them, their update publications and some research associated to brace effectiveness.
It’s important to letting you know that research in this area is very productive and today we do not have a common and generally accepted knowledge base, and that instead, individual expertise still prevails, giving rise to different schools of thought on brace construction and principles of correction. That’s the reason why SOSORT is working on create more evidence in this area and they are looking to establish a single and comprehensive source of information about bracing. You can find more information in the “Brace Technology” Thematic Series at http://www.scoliosisjournal.com/series/brace_technology, where technical papers coming from the different schools are continuously published.
Symmetric braces have pad inlays that push on the most prominent areas of the scoliotic trunk. Those are:
a. Milwaukee Brace:
b. Boston Brace:
c. Lyon Brace: Tries to maintain the correction after a plaster cast reduction in the Cotrel’s EDF (Elongation-Derotation-Flexion) frame. It is an adjustable multi-shell brace that has been used for more than 60 years. If you need more information, click here to see its recent publication.
d. SPoRT Brace:”SPoRT” is the acronym for “Symmetrical Patient oriented Rigid Tree-dimensional Braces”, and is the name to define three types of braces: Sforzesco, Sibilla and Lapadula braces. If you need more information, click here to see its recent publication.
Asymmetric braces are constructed in an attempt for overcorrection sometimes with foam pads used for augmentation in the pressure areas but also for providing spaces on the opposing sides of the pressure areas. Those are:
a. Chêneau Brace:
b. Rigo System Chêneau Brace: This brace incorporates expansion and pressure areas to treat all aspects of the 3-dimensional scoliotic deformity not only in the frontal plane but also in the sagittal and transverse planes. . If you need more information, click here to see it recent publication.
c. Art Brace: It is also known as the new Lyon brace and is an immediate corrective brace based on some of the principles of the plaster cast which are improved due to advances in CAD/CAM technology. If you need more information, click here to see it recent publication.
d. Scoliologic Brace: It is a derivated of Chêneau Brace, and it has two types: The Gensingen brace that is for thoracolumbar scoliosis and the Chêneau light is for right thoracic and left lumbar curvatures, only. To design it, the patients' trunk is scanned with the help of a whole trunk optical 3D-scan and the patients' data from the clinical measurements are recorded, a model of the brace can be created by modifying the trunk model of the patient 'on screen' to achieve a very individual brace model using the CAD/CAM tools provided or by choosing a brace model from our library and re-size it to the patients' properties 'on screen'. If you need more information, click here to see it recent publication.
e. Progressive action short Brace (PASB): Is a custom-made thoraco-lumbar-sacral orthosis designed to overcome the limits imposed by the trunk anatomy. Indeed, the particular geometry of the brace is able to generate internal forces that modify the elastic reaction of the spine. The PASB is indicated for the conservative treatment of lumbar and thoraco-lumbar scoliosis. If you need more information, click here to see it recent publication.
f. Thoracolumbar lordotic intervention brace:
g. Gomez Brace:
h. LA Brace: If you need more information, click here to see it recent publication.
Here you will find the link to the original research document and a brief detail of its conclusions:
Bracing is effective in stopping or slowing the progression of curves. Bracing significantly decreased the progression of high-risk curves to the threshold for surgery. 72% of all braced participants had a successful outcome (stabilized or improved curves were considered success)
A significant positive association between hours of brace wear and rate of success exists.
There is a correlation between bracing outcome and Orthotist skills and competence. With a better in-brace correction, the outcome will be better. Highlights need for advancement in research, Orthotist training, and brace design.