Back

Opinions Vary About Bracing for Scoliosis

What happens to children with scoliosis (curvature of the spine) if they aren't treated? Do they stay the same, get better, or get worse? Bracing is the standard treatment for curves that measure more than 45 degrees.

But what would happen to these children if they didn't wear a brace? Can a study be done to compare children with braces to children without bracing? So far this hasn't been done because it isn't ethical. Not bracing a child with scoliosis is the same as denying that child treatment.

In this study, researchers survey more than 50 pediatric orthopedic surgeons on this topic. Case examples of possible patients were presented. The surgeons were given choices about different ways to treat each one. They were asked to guess (estimate) how many patients could be treated successfully with and without bracing.

The number of surgeons who responded to the survey was very low. The authors decided to put together an expert panel from those who did reply. Again, the surgeons were asked to give estimates on the success of treating scoliosis with and without bracing. They were given 12 different patient profiles to judge.

There was general agreement that bracing works much better for girls before they start their first menstrual cycle (premenarchal). This opinion was the same for both small and large curves. The group agreed that large single or double major curves in postmenarchal girls aren't as likely to respond to bracing.

There was a wide range of opinion over the success of bracing. Only about one-third of the group agreed about the benefits of bracing. The authors suggest that studies to compare results with and without bracing can be justified.

They say it's not right for patients to suffer the cost or the discomfort for a treatment that hasn't really been proven beneficial. Two-thirds of the expert panel agreed with this conclusion.

References: Lori A. Dolan, PhD, et al. Professional Opinion Concerning the Effectiveness of Bracing Relative to Observation in Adolescent Idiopathic Scoliosis. In Journal of Pediatric Orthopaedics. April/May 2007. Vol. 27. No. 3. Pp. 270-276.

Back