When it comes to scoliosis treatment, it’s important that patients and their families are informed. Scoliosis can change quickly, but in many cases, it can be highly responsive to conservative treatment. Knowing how different scoliosis braces compare in treatment can help patients make informed treatment choices.
There is a significant difference between traditional scoliosis braces like the Milwaukee brace and the modern ScoliBrace®. While the Milwaukee brace uses 3-point pressure pads to immobilize the spine, the ScoliBrace® uses Mirror Image® and harnesses the use of spinal coupling and over-correction for 3-dimensional results.
Let’s compare the design and efficacy of the traditional Milwaukee brace to the modern ScoliBrace®.
Scoliosis Bracing
Scoliosis patients have a lot happening in and around their spines. Scoliosis causes the spine to bend unnaturally to the side, and its vertebral rotation makes scoliosis 3-dimensional.
An unnatural spinal curve doesn’t just affect the spine, but also its surrounding muscles and nerves, and a misaligned spine can have widespread effects.
Scoliosis is also progressive, and progression of the curve is triggered by growth, so timely curve correction is a goal of treatment, particularly in cases of childhood scoliosis where constant growth is occurring (3, 7).
While there is a place for bracing in adult scoliosis treatment, braces are used more for pain relief and spinal stabilization (3).
Scoliosis has been around since ancient times and scoliosis bracing is not a new concept, but there have been a number of advancements made over the years in bracing design and efficacy, based on observation, research, and evidence.
A scoliosis brace is an orthotic device that’s worn around the torso with the goal of addressing scoliosis. There are different types of braces, however, and it’s important that patients understand what a potential brace has to offer, along with its limitations.
It’s also important for patients to understand that no brace on its own is enough for correction, but when combined with the power of a scoliosis-specific exercise program, a whole approach can be crafted for 3-dimensional correction.
The basic design of a scoliosis brace is based on altering the curve by applying external forces to the spine, but the force can be applied in different ways for varying results (3).
Let’s talk about the Milwaukee brace as a traditional scoliosis brace.
The Milwaukee Brace
The design of the Milwaukee brace is important because it contributes to its biggest challenge: compliance.
No scoliosis brace can be effective if it’s not being worn exactly as prescribed, regardless of how comfortable it is or what it looks like.
The Milwaukee brace supports the upper body and extends from the pelvis to the neck with the goal of improving the spine’s position; it consists of a rigid pelvic girdle, a thoracic pad, neck ring, and metal bars.
The Milwaukee brace is commonly prescribed to maintain a straight and upright posture and prevent progression during periods of rapid growth; via a 3-point pressure pad system, it squeezes the spine into a straighter alignment.
A prescription for full-time brace wear can be for up to 23 hours a day.
While the Milwaukee brace has shown limited success with improving the spine’s function and reducing curve size, compliance can be a challenge, and it has also been associated with some negative effects.
Potential Negative Effects of the Milwaukee Brace
Considering the main age group affected by scoliosis are adolescents, it’s not surprising that some common bracing effects aren’t physical.
Adolescent patients, in particular, are vulnerable to the psychological effects of body image and social anxiety, and most teenagers want to look like their peers; they don’t want to wear a cumbersome snug fitting scoliosis brace with metal uprights to school every day, and this can lead to the issue of compliance (3).
In addition, the rigid squeezing design of the Milwaukee brace has also been associated with discomfort, restricted movement, skin irritation, weak muscles, and breathing difficulties.
Body image concerns are a huge challenge to potential treatment success with traditional braces like the Milwaukee brace because they aren’t fully customized to each patient so can be uncomfortable and difficult to conceal under clothes.
What ScoliCare Clinicians observed was the need for a more-advanced brace, one that can take the potential benefits of traditional bracing, make adjustments accordingly, and improve and apply what we’ve learned about scoliosis over the years.
And what we’ve learned is that corrective bracing, when combined with the power of scoliosis-specific exercises, has the power to impact scoliosis on multiple levels.
The ScoliBrace
The ScoliBrace® is the world’s most advanced scoliosis brace and is only available through ScoliCare Clinics and certified ScoliBrace® providers (3).
The ScoliBrace® combines known benefits of scoliosis bracing with the power of innovative over-corrective brace design and evidence-based customization.
The ScoliBrace® is a custom 3-dimensional scoliosis brace used to treat scoliosis in children, adolescents, and adults (5).
The customization of each brace makes it as comfortable as possible; just as no two bodies are the same, no two braces should be.
Our innovative approach to bracing uses state of the art technology to ensure measurements are precise so each brace can be customized to its wearer’s body and curve type: improving rates of compliance.
Computer-aided design and 3-dimensional scanning technology apply a patient-centered approach to brace design that’s unparalleled.
ScoliBrace® Design and Function
What really sets the ScoliBrace® apart from traditional bracing counterparts is its design.
While some traditional braces immobilize the spine during brace-wearing, the ScoliBrace® works towards improving the spine’s alignment and posture so movement can be maintained while wearing the brace.
Allowing for more movement while wearing the brace means that muscle strength is easier to maintain, and the spine needs strong and balanced muscles for support and stability.
By placing the spine in an over-corrective position, Mirror Image® position, and using spinal coupling, the ScoliBrace® is working towards impacting 3-dimensional posture and body positioning, versus a 3-point pressure system that squeezes the spine from the sides and is more commonly associated with 2-dimensional results.
While the body is in a healthier position, the ScoliBrace® also has the potential to retrain the neurological connection between the brain, the spine, and its surrounding nerves and muscles; this can help restore the body’s posture and alignment.
Because the ScoliBrace® allows for movement and isn’t known to weaken the spine’s surrounding muscles, when combined with an exercise-based approach to scoliosis treatment, the motivating results of treatment can further improve a patient’s physical and mental health (3,7).
ScoliCare patients also benefit from what ScoliBalance® has to offer; as a scoliosis-specific exercise program that can slow/stop progression, increase the spine’s strength and flexibility, teach postural awareness, and improve the spine and body’s balance, managing scoliosis effectively with conventional treatments can be within reach (3,7).
Conclusion
The traditional Milwaukee brace is a rigid scoliosis brace that is more known for its 2-dimensional squeezing effect than 3-dimensional correction; it’s also associated with some negative physical and mental effects.
Due to its rigid design and effect of restricted movement, skin irritation, breathing problems, activity restrictions, and muscle atrophy are associated with long-term brace use, and while the Milwaukee brace has shown limited success with controlling progression and reducing the curve, the emotional well being of adolescent patients also has to be considered.
The modern ScoliBrace® has a lot to offer its patients: from 3-dimensional customization for a brace that’s more flexible, comfortable, easily concealed under clothes, to its corrective potential.
The ScoliBrace® even offers patients further customization with different color and pattern options, and the ScoliBrace® was also designed to open and close at the front so it can easily be put on and removed for a smoother integration into daily life.
ScoliCare Clinicians listened to patients and their experiences with certain traditional scoliosis braces described as uncomfortable and embarrassing to wear. Even with early detection, if a brace isn’t comfortable enough to facilitate compliance, its potential efficacy is limited from the start.
ScoliCare Clinicians extracted valuable lessons from the successes and limitations of traditional scoliosis bracing and designed a brace with customization, compliance, and the potential to alter the spine’s position.
The ScoliBrace® is also paired with a powerful physiotherapeutic scoliosis-specific exercise program for a complete approach to treating scoliosis in children, adolescents, and adults: ScoliBalance®.
Because the ScoliBrace® was designed with movement in mind, scoliosis-specific exercises can also be applied for improved muscle endurance, spinal flexibility, and curve correction.
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
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