Your son is in the middle of treatment for a juvenile scoliosis. It is hard work for both the parent and the child or young person (sometimes themselves). Between physical therapy, orthotics of various types, or even spinal surgery in extreme or sometimes unnecessary cases, it would be reassuring to know that the improvement and correction of spinal curvature will be permanent over the long term.
The right time for a brace treatment is during your child's growth spurt. We know that brace treatment is effective in slowing the progression of the curve, but questions remain about long-term stabilization into adulthood and beyond. There is still some controversy about scoliosis braces among certain homeopathic doctors. In this article, we discuss the short- and long-term efficacy of scoliosis braces in children and adolescents with adolescent idiopathic scoliosis.
Let's look at a real-life case of a girl with adolescent idiopathic scoliosis. The case we are investigating is the treatment of an eleven year old girl. (For ease of explanation, we call this girl Lisa, since privacy has prevented publication of her name.) Lisa's treatment began at age eleven and weaning from the orthosis at fifteen, as no residual growth was expected by the scoliosis specialists and her doctor.
When Lisa started treatmentthe Rigo-Cheneau disasterhis Cobb angle was thirty-eight degrees. After two years of bracing, the Cobb angle was reduced to nineteen degrees. The Cobb angle increased slightly to 14 degrees on settling. When Lisa turned 21, five and a half years after weaning, there was no change in the Cobb angle, which stabilized at nineteen degrees. Lisa and her happy parents were very happy with thattreatment resultand Lisa is fully functional in every way.
Why does the idea persist that braces don't work when so much research and case histories show the opposite? This statement has a practical side for non-medical professionals, such as chiropractors and nutritionists, to promote and sell their treatment plans. His statements may be true for small Cobb curves of less than twenty-five percent. Especially for actively growing children and adolescents — all with a Cobb curve greater than 25 percent — uncorseted treatment is quite risky and even dangerous, and has lasting effects when they grow up. In fact, there was a big well-known study called:The BraIST studywhich ended prematurely for ethical reasons. Why allow a child with scoliosis to be treated with questionable non-braces treatment and put them at long-term risk when the data clearly show that there is a high probability of permanent and irreversible damage?
Chiropractors like Dr. Jordan Ax use muscle building techniques and gentle braces. These ideas in themselves seem attractive, but only if the Cobb curvature is negligible or less than 25 degrees. However, with a strong curve, it is not enough to tighten and strengthen the muscles, because the problem is not the muscles, but the bone structure of the back. Let's compare it to a broken bone. For example, if a person can wear a soft cast for a small, large fracture, but for other more serious fractures, a hard cast should be used. Likewise, a person with a large curvature of the spine needs a rigid support to realign and secure the bone structure itself. Doctor Ax claims that the correction is lost once the patient is off the brace, which sometimes requires surgery afterwards. Ifgood bracing practicesCredible scientific evidence is used to prove these claims are false.
The 2013 by Dr. Stuart Weinstein, the BraIST study is one of the most important conclusive studies on the benefit of braces in juvenile idiopathic scoliosis. Nine other studies met the Scoliosis Research Society criteria, confirming that braces are the most successful treatment available. In fact, each of these studies confirmed that the average treatment success rate is 85.4%. As of last year, 2019, the aforementioned society has confirmed that the brace is successful in treating most patients with Juvenile Idiopathic Scoliosis.
When 10-year-old Maddie Houser from North Liberty, Iowa was diagnosed with scoliosis, her mother, Becky, wanted to avoid surgery at all costs, so she volunteered to take her daughter to Dr. to bring Weinstein. Becky has had her own experience with scoliosis surgery. Becky spent three weeks in the hospital and nine months in a cast when she had surgery thirty years ago.
At thirteen, Becky's daughter, Maddie, received the good news that she was no longer needed.scoliosis bracewhen her growth spurts stopped and she was stable at a 28 degree curve.
dr Weinstein presented his findings at the forty-eighth annual meeting of theSociety for Scoliosis Research, in Lyon, France. At the same time, he published the results of his study online atThe New English Journal of Medicine.. Several medical institutions worked simultaneously on a state-of-the-art medical study to answer the question of how effective the orthosis is in children and adolescents. 242 patients at 25 locations in the United States and Canada have seen Dr. enrolled in Weinstein. The children who were still growing up were between ten and fifteen years old. His Cobb grades ranged from twenty to forty degrees.
A special monitor was placed in the brace of patients in the brace group to track how long the brace was worn each day. The prescription for this study was eighteen hours. (The time frame has recently been increased to 23 hours in many scoliosis centers.) There was a control group who did not receive braces. In the group that wore the belt, 72 percent of users avoided any type of surgery, while more than 50 percent in the control group required corrective surgery. An increase in wear time of thirteen hours or more increased the success rate by ninety percent. Thecomplete studythat not only was wearing the brace crucial to recovery, but also how long the brace was worn. The strong evidence for the value of braces treatment was particularly valuable for adolescents at high risk of surgery.
A New York Times article concluded that wearing a scoliosis brace slows the progression of idiopathic scoliosis in adolescents and avoids surgery. As stated above, the trial was canceled earlier than originally planned due to the level of bracing play.
A study from 2017Angel AulisaHe accompanied patients for fifteen to twenty years after completing the scoliosis brace. Over a 21-year period, 209 adolescents with scoliosis participated in Aulisa's study. All curves (with a three degree slope) remained the same fifteen years after the end of treatment. What the curve was before didn't matter whether the curve before was less than thirty degrees or more than thirty degrees.Start of treatment with vest.
In the last forty to fifty years there have been long term studies suggesting that depending on the size of the curvature, scoliosis can get worse if left untreated. Even after the patient stops growing, thethe deterioration will continueespecially when the turn is over fifty degrees. Studies that have followed patients for up to twenty years after spinal correction surgery involving screws, rods and bone fusion have found that the curves may continue to increase.
Finally, removing a vest that your child or teen has worn for several years is a highlight to cherish. Seeing the results and improvement is undoubtedly a happy moment for both the parent and the child. The celebration is certainly in order with a trip to the mall for a trendy new wardrobe and a peaceful night's sleep. A parent would be even happier if they could be sure that their child's progress and the greatly reduced Cobb angle, measured after the orthosis was removed, are permanent. From the large studies that have been conducted, it appears that the answer is yes. Although the Cobb angle increases slightly with adulthood, the patient's quality of life does not decrease. By learning to stand up, along with regular exercise, the adult scoliosis patient stands a good chance of never returning to the bumpy appearance of their childhood.
With the increasing acceptance of the brace as the treatment of choice for juvenile idiopathic scoliosis, we will see more studies on the success of its treatment. There are so many different types of devices these days, each specifically designed to deliver the precious patient's ideal therapy. Looking ahead is always beneficial with any type of temporary therapy, be it psychological, physical, or even dietary. Seeing real patient case histories similar to your own child will help you and your child look forward to a successful future, and the sight of the vest in the closet, basement or garage will become a reminder of victory and the perseverance of your child as a parent. Your child is confident of achieving their goal.
What are the long term effects of scoliosis bracing? ›
Side effects of scoliosis bracing
There are some concerns that wearing certain types of braces for long periods of time can immobilize the spine and the muscles, accelerating the process of disc degeneration and causing muscle atrophy and weakness.
Braces have been used to treat scoliosis for over 450 years, but there are still questions about their effectiveness. Braces can only slow or stop the progression of a spinal curve. They can't get rid of the curve or straighten out the spine.What is the success rate of bracing for scoliosis? ›
About scoliosis bracing
Of these patients, about 75 percent are successfully treated with scoliosis bracing. The other 25 percent go on to need spinal fusion surgery. Orthopedic doctors typically recommend scoliosis bracing for kids and teens who are still growing and have a curvature of 25 degrees or more.
Bracing works best when a child is growing and before the curve is too big. Bracing ends after a child stops growing. That can take a couple of years. How long kids wear scoliosis braces depends on their curve and when they're done growing.