Despite carefully wearing a nighttime brace for scoliosis, our 10 year old's curve is getting worse. What do we do now?

Nighttime bracing for juvenile idiopathic scoliosis (JIS) must be worn at least eight hours during each 24-hour time period to be successful. Most children choose to wear the brace during sleep. That way they don't have to wear it to school or during social activities.

Brace treatment is considered a failure if either the major or the secondary curve continues to get worse. Progression of more than five degrees requires follow-up treatment. The first thing to do is check to make sure the brace is really being worn as recommended. Then the fit should be double-checked. It's possible the child has grown and the brace no longer fits properly.

Surgery may be needed but this depends on how close the child is to skeletal maturity. If the child is no longer growing, then curve progression may be stopped. Surgery may not be needed if that's the case. But if the curve has continued to get worse and now measures more than 45 degrees, then spinal fusion may be needed.