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. 2019 Oct 8:10:153-172.
doi: 10.2147/AHMT.S190565. eCollection 2019.

Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date

Nikos Karavidas  1
Affiliations

Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date

Nikos Karavidas. Adolesc Health Med Ther. .

Abstract

Brace effectiveness for adolescent idiopathic scoliosis was controversial until recent studies provided high quality of evidence that bracing can decrease likelihood of progression and need for operative treatment. Very low evidence exists regarding bracing over 40ο and adult degenerative scoliosis. Initial in-brace correction and compliance seem to be the most important predictive factors for successful treatment outcome. However, the amount of correction and adherence to wearing hours have not been established yet. Moderate evidence suggests that thoracic and double curves, and curves over 30ο at an early growth stage have more risk for failure. High and low body mass index scores are also associated with low successful rates. CAD/CAM braces have shown better initial correction and are more comfortable than conventional plaster cast braces. For a curve at high risk of progression, rigid and day-time braces are significantly more effective than soft or night-time braces. No safe conclusion on effectiveness can be drawn while comparing symmetrical and asymmetrical brace designs. The addition of physiotherapeutic scoliosis-specific exercises in brace treatment can provide better outcomes and is recommended, when possible. Despite the growing evidence for brace effectiveness, there is still an imperative need for future high methodological quality studies to be conducted.

Keywords: brace; evidence; non-operative treatment; orthosis; scoliosis.

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Conflict of interest statement

The author reports no conflicts of interest in this work.

Figures

Figure 1
Figure 1
In-brace correction is the most important predictive factor for successful brace treatment.
Figure 2
Figure 2
A rigid brace on the left side and a soft brace on the right side of the photo.
Figure 3
Figure 3
An asymmetric brace on the left side and a symmetric brace on the right side of the photo.
Figure 4
Figure 4
Physiotherapeutic scoliosis-specific exercises.
See this image and copyright information in PMC

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