Bracing

Bracing has been used as an early intervention treatment for scoliosis for decades. Over the years the way that scoliosis braces are designed and manufactured has evolved.

Traditional Braces

Traditional scoliosis braces, which are called Thoracto-Lumar-Sacral-Orthosis (TLSO), work by attempting to hold the spine in place and are not corrective braces. Essentially traditional braces treat the spine like a fracture using three-point pressure to immobilize the area. This is the underlying theory behind most scoliosis braces, such as the Boston Brace, and has only shown moderate success in stopping scoliosis curves worsening and needing surgery#*.

The biggest ever randomized control trial done on traditional scoliosis braces, the BRAIST Study*, reported a 72% success rate for bracing compared to no brace treatment. However, the measure of success in this study was scoliosis curves not worsening during treatment to the point where the patient required surgery. In other words, a patient could have started with a 25 degree curvature (Cobb angle), the scoliosis could have worsened during treatment to 45 degrees but that patient would have still been considered a success because the curve degree didn’t reach the point where surgery was recommended. In the study, surgery was required at a curve of 50 degrees.

#Thompson, G. H. (2007). A Comparison of the Thoracolumbosacral Orthoses and Providence Orthosis in the Treatment of Adolescent Idiopathic Scoliosis. J Pediatr Orthop, 27, 369Y374.
*Weinstein, S. L., Dolan, L. A., Wright, J. G., & Dobbs, M. B. (2013). Design of the bracing in adolescent idiopathic scoliosis trial (BrAIST). Spine, 38(21), 1832.

 

Custom Designed Rigid Braces

After years of research into the effect of mirror image rehabilitation, 3D designed and manufactured scoliosis braces have been developed. This approach considers the patient’s postural alignment and the scoliosis deformity in three dimensions. Based on this 3D assessment, computer-assisted design and manufacturing are used to produce a brace that attempts to correct the patient’s postural and spinal deformity in all three planes.

BraceScan 3D Body Scanning

ScoliCare believes there is a better way!

Our approach to bracing brings together the most advanced technology,  evidence-based techniques and experienced clinicians to get the best possible outcome for patients with scoliosis. We offer the world’s most advanced scoliosis brace called ScoliBrace®.

Using a structured light scanner that attaches to an iPad, our BraceScan software allows our clinicians to capture full 3D body scans of a patient in any position. These multiple 3D scans, digital X-rays, posture photos and other clinical information are used to design a truly 3D over-corrective custom brace.

The BraceScan software removes many of the inaccuracies of traditional bracing, such as plaster casting, and captures the most important patient data in an accurate and reliable way to ensure that the end product, the ScoliBrace, is the most effective brace.

The ScoliBrace’s over-corrective approach and asymmetrical design harnesses spinal coupling, not 3 point pressure

Unlike traditional bracing approaches, the ScoliBrace‘s over-corrective approach and asymmetrical design harnesses spinal coupling, not 3 point pressure, individualizing the correction to achieve an improved alignment of the spine and body posture in the brace.

It ideally achieves an overcorrection or mirror image position of the three-dimensional posture of the body. By achieving this 3D overcorrection, it puts a spine with scoliosis in the straightest possible position.

Types of Scoliosis Bracing

In infantile cases, where there is demonstrated worsening of the curve, serial scoliosis bracing can be an effective option.

Traditionally infants are treated with a plaster cast when the curve is severe. Casting infants requires them to be anesthetized. Intervening earlier when the curve is smaller and more flexible with a ScoliBrace has the advantage of avoiding general anesthetic. The ScoliBrace can also be removed for bathing and in smaller curves, part-time bracing is often the protocol of choice.
Juvenile curves have a high risk of progression. When bracing juvenile curves it is important to try and achieve a reduction in the size of the curve before the juvenile reaches the adolescent growth spurt.

During treatment, if the juvenile curve can be reduced to under 20 degrees then a part-time protocol can often be used to maintain a curve in this range until the adolescent growth spurt.
The primary goal of brace treatment in adolescents is to stabilize the curve and stop progression. However cosmetic issues such as asymmetrical or uneven postures, a protruding hip or rib cage are often the main concern for patients.

Using an approach that is geared towards improving the spinal alignment and posture, such as ScoliBrace, gives the best chance at both stabilizing the curve and making postural and cosmetic improvements. In some cases, where the curve is flexible and the patient is very compliant with the treatment some measure of curve correction is often achievable.
Adults with scoliosis present in a variety of different goals of treatment.

In elderly adults with degenerative scoliosis, low back and leg pain are often the main complaint regarding their scoliosis. In these cases the spine may have some instability in the form of lateral listhesis. Bracing can be very effective in stabilizing the spine and reducing pain.

In younger adults, cosmetic and postural complaints are often the main issue. In these cases the 3D corrective nature of the ScoliBrace has the best chance at improving the postural cosmetic concerns.

Success Stories
From Our Clinics

We’d like to thank our patients for their permission to use their images and results in our case studies. These studies are not to be reproduced without written permission from ScoliCare.

Case – Adult Bracing (88 year old female)

Female aged 88 years with a degenerative de novo scoliosis because of earlier spinal trauma many years earlier. Improvement of a severe post-traumatic de novo degenerative scoliosis using 3D designed custom scoliosis brace in an older female Summary: This case details the successful management using a a 3D designed custom…

Case – Adult Bracing (87 year old female)

Female aged 87 years with adult degenerative scoliosis. Treatment of a severe scoliosis using a 3D designed custom scoliosis brace in an Older Female Patient Summary: This case details the management of an older female with Adult Degenerative Scoliosis using a 3D designed custom scoliosis brace. The patient initially presented…

Case – Adolescent Bracing (14 year old female)

Female aged 14 years with a 34° thoracolumbar curve. Reduction of Severe Scoliosis using a 3D Designed Custom Scoliosis Orthosis in a Young Active Female Summary: This case details the successful management of a young active female with adolescent idiopathic scoliosis (AIS) using a using a 3D designed custom scoliosis…

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