Scoliosis bracing has been used in scoliosis treatment for centuries, and while the concept of bracing isn’t new, we’ve learned a lot about scoliosis-brace efficacy over the years; ScoliCare Clinicians applied that knowledge to the design of the world’s most advanced scoliosis brace: the ScoliBrace®.
The most commonly prescribed scoliosis brace in traditional treatment is the Boston Brace, which uses a 3-point pressures system to impact scoliosis in 2 dimensions; as a 3-dimensional condition, the modern ScoliBrace® works towards improving the body’s 3-dimensional posture and positioning.
As the ScoliBrace® and the Boston Brace are associated with different treatment approaches, let’s talk generally about what this means.
Scoliosis Treatment Approach
There are two main scoliosis treatment approaches and patients need to understand how each can shape future spinal health.
Traditional scoliosis treatment often includes a surgical response when/if a certain severity level is reached, but does little beforehand to prevent progression from occurring (6).
Scoliosis is progressive; its nature is to increase in severity over time, and scoliosis ranges from mild to moderate and severe cases.
In most cases, we don’t know what causes the scoliosis to develop, but we know growth spurts are the main trigger for progression, so the more growth a patient has to go through before reaching skeletal maturity can also indicate a patient’s potential progression (3, 7).
Traditional treatment doesn’t have an approach for addressing scoliosis while mild, so a recommendation to watch and wait is common, but what happens when a significant adolescent growth spurt occurs? Rapid progression can occur, making treatment more challenging.
Modern conservative treatment is proactive, not reactive; its goal is to prevent progression and the need for invasive future surgical treatment (7, 6).
Conservative treatment options work towards 3-dimensional correction because as scoliosis doesn’t just cause the spine to bend unnaturally to the side but also rotate, scoliosis is 3-dimensional, and treatment that addresses it as 2-dimensional is going to be limited in its potential efficacy.
One of the most significant differences between the modern ScoliBrace® and the traditional Boston Brace is its 3-dimensional, versus 2-dimensional corrective potential (3).
How Can ScoliBrace Help?
The ScoliBrace® is a customized 3D evidence-based spinal brace used to treat scoliosis in children, adolescents, and adults (3).
As part of a conservative treatment approach, the ScoliBrace® features an innovative design that addresses issues associated with traditional braces like the Boston Brace.
The main issue with scoliosis bracing is compliance. While scoliosis can affect all ages, it’s most frequently diagnosed during adolescence as adolescent idiopathic scoliosis, and this age group isn’t generally known for their compliance (2).
It’s important for many teens to look and walk like their peers, and not all scoliosis braces are designed with comfort and discretion in mind; ScoliCare Clinicians observed this challenge of traditional bracing and recognized the need for something new, something innovative and customized (2, 3, 5).
Individualization is at the heart of the ScoliBrace® design, and the most advanced scanning technology and computer aided design ensures that each individual patient is fitted with the most comfortable and concealable brace possible.
The ScoliBrace® is also designed to be easily put on and taken off from the front, and there are a number of pattern/color options patients can choose from for further customization.
The ScoliBrace® isn’t just unique in its patient-based design, but also its function.
Spinal Coupling Versus Immobilizing the Spine
Spinal coupling is based on natural movement and occurs when a primary motion automatically triggers a secondary motion, like how spinal rotation accompanies a sideward spinal-bend (3).
The ScoliBrace’s asymmetrical design uses spinal coupling versus a 3-point pressure system.
The mindset of traditional scoliosis treatment is to immobilize the spine (limit its movement); this is what occurs in scoliosis surgery that fuses the spine and immobilizes it with metal rods.
Traditional bracing has the same general concept in mind: limiting the spine’s movement can mean stopping progression.
The ScoliBrace® also has the goal of counteracting progression, but its design is based on a different functional approach.
The ScoliBrace® approach doesn’t involve immobilizing the spine; it places it in an over-corrective position to improve the body’s position and posture (3).
While being held in a corrective position, the brace also works towards neurological retraining to improve the connection between the brain, the muscles that surround the spine, and the joints that are involved in posture.
Immobilizing the spine involves a 3-point pressure system that applies intense pressure to strategic points of the unnatural spinal curve, but this may weaken the spine over time, and as it limits movement, can also contribute to a loss of muscle strength and balance.
The ScoliBrace® is designed to function during movement so it’s better for core strength and maintaining spinal flexibility: a key factor in how responsive the spine is to treatment.
And an approach that works towards preserving the spine’s natural range of motion is going to be one that’s more aligned with the spine’s natural function.
So to summarize, the main features of the ScoliBrace® include its custom-designed fit, ability to maintain movement and muscle strength, and over-corrective approach that relies on spinal coupling versus 3-point pressure pads (3).
The Boston Brace
The Boston Brace is the most commonly used brace in traditional scoliosis treatment and its goal is to stop progression through immobilization; immobilizing the spine means limiting its movement
The Boston Brace doesn’t treat scoliosis as 3-dimensional, only addressing its unnatural lateral bend, but not the spine’s rotation.
The Boston Brace has shown some success in slowing/stopping progression, particularly in scoliosis that develops in the thoracic spine, but when it comes to 3D improvements to posture and body positioning, corrective bracing has more to offer.
One of the biggest challenges to bracing success is compliance, and when a brace is rigid and not as easy to conceal under clothes, this can limit a brace’s potential efficacy.
And as the ScoliBrace’s ultra-corrective design allows for movement, when combined with exercise-based treatment, muscle health and spinal flexibility can be improved (3).
ScoliBalance®
ScoliBalance® is an effective physiotherapeutic scoliosis-specific exercise program for treating scoliosis in patients of all ages (3, 5, 2)
The ultimate goal of ScoliBalance® is to restore balance to the spine and body; it takes the best of what chiropractic care, physical therapy, and exercise rehabilitation has to offer and integrates it into an individualized rehabilitation treatment plan (3).
Largely through the use of Mirror Image® Exercise, patients are taught how to hold their spines and bodies during movement/daily activities to counteract the spine’s unnatural bend and twist, and this type of awareness can facilitate postural restoration that helps sustain treatment results (3).
Through 3D postural correction, the spine’s position may be improved, and once patients are comfortable with the program in-clinic, they can perform the exercises from home to further stabilize the spine.
When combined with the potential of a corrective brace like the ScoliBrace®, there can be fewer limits to what conservative treatment can offer (3).
Conclusion
While no treatment results can ever be guaranteed, the combined results of the innovative ScoliBrace® and an equally-individualized scoliosis-specific exercise program like ScoliBalance® can include managing progression, curvature reductions, pain relief, improving the spine and body’s balance, posture, surrounding muscle balance and strength.
Traditional braces like the Boston Brace, the milwaukee brace, the providence brace, the charleston bending brace, and the wilmington brace have shown limited success in improving the spine’s position and managing progression, but additional effects can include weak muscles, increasing spinal rigidity, and restricted movement.
In addition, the Boston Brace doesn’t involve a custom fit, so compliance issues can further limit the brace’s potential efficacy; brace wear has to be consistent and as prescribed.
Full time bracing recommendations can be for up to 23 hours a day, so ensuring a brace fits properly can directly affect compliance and potential treatment success.
Here at ScoliCare, our Clinicians work closely with patients to customize bracing options and scoliosis-specific exercise programs for the most precise and comprehensive treatment results.
References:
- Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis: National Library of Medicine
- Weinstein SL. The Natural History of Adolescent Idiopathic Scoliosis. J Pediatr Orthop. 2019 Jul;39(Issue 6, Supplement 1 Suppl 1):S44-S46. doi: 10.1097/BPO.0000000000001350. PMID: 31169647.
- Marchese R, Du Plessis J, Pooke T, McAviney J. The Improvement of Trunk Muscle Endurance in Adolescents with Idiopathic Scoliosis Treated with ScoliBrace® and the ScoliBalance® Exercise Approach. J Clin Med. 2024 Jan 23;13(3):653. doi: 10.3390/jcm13030653. PMID: 38337346; PMCID: PMC10856658.
- Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. doi: 10.1186/s13013-017-0145-8. PMID: 29435499; PMCID: PMC5795289.
- Scoliosis in Children and Teens: National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Comparison of Functional Outcome and Quality of Life in Patients With Idiopathic Scoliosis Treated by Spinal Fusion: National Library of Medicine
- Screening for the Early Detection of Idiopathic Scoliosis in Adolescents: American Academy of Orthopaedic Surgeons
- Marty-Poumarat, Catherine MD*; Scattin, Luciana MD†; Marpeau, Michèle MD*; Garreau de Loubresse, Christian MD‡; Aegerter, Philippe MD, PhD§. Natural History of Progressive Adult Scoliosis. Spine 32(11):p 1227-1234, May 15, 2007. | DOI: 10.1097/01.brs.0000263328.89135.a6
