Case Study: Bracing of Adolescent with Idiopathic Scoliosis

This month we take you behind the scenes of the treatment story of a 14 year old girl with adolescent idiopathic scoliosis who opted for a ScoliBrace. Let’s call her Sasha (name changed). 

Sasha presented to ScoliCare with a 34 degree left thoracolumbar curve after receiving some initial treatment elsewhere. You can see the X-Rays below indicating her curve:

  • before assessment at ScoliCare (Figure 1)
  • at the initial assessment at ScoliCare (Figure 2)

From there, take a look at her posture photo and angle of trunk rotation (ATR) from the initial assessment (Figure 3). You can clearly see her left trunk translation and the structural deviation presenting in her Adam’s Forward Bend Test. 

                                                                          Figure 1: X-Ray before initial assessment at ScoliCare    

                                                                           Figure 2: X-Ray at initial assessment at ScoliCare 

Figure 2- X-Ray at initial assessment at ScoliCare

                                                                             Figure 3: Initial posture and Adams Forward Bend Test

 

Treatment of Choice – ScoliBrace

Sasha and her family decided that their treatment of choice would be to use a ScoliBrace and participate in an intensive rehabilitation protocol. You can see Sasha participating in exercises designed to actively correct her posture (Figure 4), in addition to wearing her ScoliBrace (Figure 5). 

                                                              Figure 4: Scoliosis specific exercise rehabilitation – ScoliBalance program

 

                                                                                                  Figure 5: The ScoliBrace

Her in-brace X-Ray clearly shows a marked in-brace correction with a measurement of only 6 degrees (Figure 6). 

 

                                                                                       Figure 6: In-brace correction

Achieving good In-brace correction can help predict success of treatment. At this stage we are quite hopeful of a good result because Sasha is committed to her treatment. 

Her 6 month (Figures 7 and 8) and 12 month (Figures 9 and 10) check-ups showed marked postural and X-ray improvements. 

 

 

                                                                                     Figure 7: Out of brace X-ray at 6 months 

                                                                                         Figure 8: Postural photo at 6 months

 

                                                                                        Figure 9: Out of brace X-ray at 12 months

 Figure 9- Out of brace X-ray at 12 months

                                                                                      Figure 10: Postural photo at 12 months

Figure-10-Postural-photo-at-12-months

 

What was the result for this patient?

This patient had a successful treatment outcome. The X-ray (Figure 11) and photos (Figures 12, 13, 14) below show a marked improvement in her:

  • Cobb angle
  • Posture
  • Adams Forward Bend test

Overall her Cobb angle reduced from the initial 34 degrees down to 18 degrees at the end of treatment (end of growth). This puts her well below any threshold for discussions of surgery. 

                                                                                           Figure 11: End of treatment X-ray

                                                                                         Figure 12: End of treatment posture photo

 

                                                                                         Figure 13: End of treatment Adams Forward Bend Test

Figure-13-End-of-treatment-Adams-Forward-Bend-Test

 

To find out more about the research to support bracing for AIS check out this research review

 

Author:

Rosemary Marchese
Physiotherapist, Scoliosis Training and Education Manager

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