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Result of Bracing or Surgery for Scoliosis

Scoliosis or curvature of the spine affects about two percent of the adolescent population. One subgroup called Adolescent Idiopathic Scoliosis (AIS) is usually a cosmetic problem more than a serious problem. This study gives a picture of the long-term results of bracing or surgery for the condition.

Bracing is used when the spinal curve is 30 degrees or more and the child is still growing. The goal is to stop the curve from getting worse and avoid spinal fusion. Surgery to fuse the spine is done with bone graft and metal rods alongside the spine. A brace is worn after surgery for at least three months.

Results are reported based on back pain, activity level, and general health status 10 years after brace or surgical treatment. Questions related to wearing the brace were also asked.

The authors report low levels of back pain in both groups. General health was the same for both groups but lower in all areas compared to adults without scoliosis. Patients were much more sports-active before treatment.

Bracing was a problem for many of the patients. They felt harassed by their peers and reserved in their interactions with members of the opposite sex. Two-thirds of the bracing group didn't wear the brace as prescribed because of skin pain or ulcers. About 10 percent quit wearing the brace for various reasons.

Doctors are concerned that children with AIS are affected by the treatment as much as by the disease. The impact of both is apparent in their early 20s. A 10-year study isn't enough to predict what will happen when these patients are in their 50s. Longer studies are needed to assess the impact in later life.

References: Mikkel O. Andersen, MD, et al. Outcome at 10 Years After Treatment for Adolescent Idiopathic Scoliosis. In Spine. February 1, 2006. Vol. 31. No. 3. Pp. 350-354.

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