Top

Clinical Orthopaedics and Related Research®

Published in:

01-03-2010 | Symposium: Pediatric Spine

Brace Management in Adolescent Idiopathic Scoliosis

Authors: Jonathan R. Schiller, MD, Nikhil A. Thakur, MD, Craig P. Eberson, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2010

Abstract

Skeletally immature patients with adolescent idiopathic scoliosis are at risk for curve progression. Although numerous nonoperative methods have been attempted, including physical therapy, exercise, massage, manipulation, and electrical stimulation, only bracing is effective in preventing curve progression and the subsequent need for surgery. Brace treatment is initiated as either full-time (TLSO, Boston) or nighttime (Charleston, Providence) wear, although patient compliance with either mode of bracing has been a documented problem. We review the natural history of adolescent idiopathic scoliosis, identify the risks for curve progression, describe the types of braces available for treatment, and review the indications for and efficacy of brace treatment.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Allington NJ, Bowen JR. Adolescent idiopathic scoliosis: treatment with the Wilmington brace. A comparison of full-time and part-time use. J Bone Joint Surg Am. 1996;78:1056–1062.PubMed

Bassett GS, Bunnell WP, MacEwen GD. Treatment of idiopathic scoliosis with the Wilmington brace. Results in patients with a twenty to thirty-nine-degree curve. J Bone Joint Surg Am. 1986;68:602–605.PubMed

Bunnell WP. The natural history of idiopathic scoliosis. Clin Orthop Relat Res. 1988;229:20–25.PubMed

Bunnell WP. The natural history of idiopathic scoliosis before skeletal maturity. Spine. 1986;11:773–776.CrossRefPubMed

Clayson D, Luz-Alterman S, Cataletto MM, Levine DB. Long-term psychological sequelae of surgically versus nonsurgically treated scoliosis. Spine.1987;12:983–986.CrossRefPubMed

Coillard C, Vachon V, Circo AB, Beausejour M, Rivard CH. Effectiveness of the SpineCor brace based on the new standardized criteria proposed by the scoliosis research society for adolescent idiopathic scoliosis. J Pediatr Orthop. 2007;27:375–379.PubMed

D’Amato CR, Griggs S, McCoy B. Nighttime bracing with the Providence brace in adolescent girls with idiopathic scoliosis. Spine. 2001;26:2006–2012.CrossRefPubMed

Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity. Spine. 2007;32:2198–2207.CrossRefPubMed

Danielsson AJ, Romberg K, Nachemson AL. Spinal range of motion, muscle endurance, and back pain and function at least 20 years after fusion or brace treatment for adolescent idiopathic scoliosis: a case-control study. Spine. 2006;31:275–283.CrossRefPubMed

10.

Dickson RA. Spinal deformity–adolescent idiopathic scoliosis. Nonoperative treatment. Spine. 1999;24:2601–2606.CrossRefPubMed

11.

Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME. The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine. 1986;11:792–801.CrossRefPubMed

12.

Fernandez-Feliberti R, Flynn J, Ramirez N, Trautmann M, Alegria M. Effectiveness of TLSO bracing in the conservative treatment of idiopathic scoliosis. J Pediatr Orthop. 1995;15:176–181.PubMed

13.

Gepstein R, Letner Y, Zohar E, Angel I, Shabat S, Pekarsky I, Friesem T, Folman Y, Katz A, Fredman B. Effectiveness of the Charleston bending brace in the treatment of single-curve idiopathic scoliosis. J Pediatr Orthop. 2002;22:84–87.CrossRefPubMed

14.

Goldberg CJ, Dowling FE, Hall JE, Emans JB. A statistical comparison between natural history of idiopathic scoliosis and brace treatment in skeletally immature adolescent girls. Spine. 1993;18:902–908.PubMed

15.

Goldberg CJ, Moore DP, Fogarty EE, Dowling FE. Adolescent idiopathic scoliosis: the effect of brace treatment on the incidence of surgery. Spine. 2001;26:42–47.CrossRefPubMed

16.

Green NE. Part-time bracing of adolescent idiopathic scoliosis. J Bone Joint Surg Am. 1986;68:738–742.PubMed

17.

Haefeli M, Elfering A, Kilian R, Min K, Boos N. Nonoperative treatment for adolescent idiopathic scoliosis: a 10- to 60-year follow-up with special reference to health-related quality of life. Spine. 1998;31:355–366; discussion 367.CrossRef

18.

Howard A, Wright JG, Hedden D. A comparative study of TLSO, Charleston, and Milwaukee braces for idiopathic scoliosis. Spine. 1998;23:2404–2411.CrossRefPubMed

19.

Janicki JA, Poe-Kochert C, Armstrong DG, Thompson GH. A comparison of the thoracolumbosacral orthoses and providence orthosis in the treatment of adolescent idiopathic scoliosis: results using the new SRS inclusion and assessment criteria for bracing studies. J Pediatr Orthop. 2007;27:369–374.PubMed

20.

Jones RS, Kennedy JD, Hasham F, Owen R, Taylor JF. Mechanical inefficiency of the thoracic cage in scoliosis. Thorax. 1981;36:456–461.CrossRefPubMed

21.

Kafer ER. Respiratory and cardiovascular functions in scoliosis. Bull Eur Physiopathol Respir. 1977;13:299–321.PubMed

22.

Karol LA. Effectiveness of bracing in male patients with idiopathic scoliosis. Spine. 2001;26:2001–2005.CrossRefPubMed

23.

Karol LA, Johnston CE 2nd, Browne RH, Madison M. Progression of the curve in boys who have idiopathic scoliosis. J Bone Joint Surg Am. 1993;75:1804–1810.PubMed

24.

Katz DE, Durrani AA. Factors that influence outcome in bracing large curves in patients with adolescent idiopathic scoliosis. Spine. 2001;26:2354–2361.CrossRefPubMed

25.

Katz DE, Richards BS, Browne RH, Herring JA. A comparison between the Boston brace and the Charleston bending brace in adolescent idiopathic scoliosis. Spine. 1997;22:1302–1312.CrossRefPubMed

26.

Korovessis P, Filos KS, Georgopoulos D. Long-term alterations of respiratory function in adolescents wearing a brace for idiopathic scoliosis. Spine. 1996;21:1979–1984.CrossRefPubMed

27.

Levine DB. Pulmonary function in scoliosis. Orthop Clin North Am. 1979;10:761–768.PubMed

28.

Lonstein JE. Scoliosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res. 2006;443:248–259.CrossRefPubMed

29.

Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am. 1984;66:1061–1071.PubMed

30.

Lonstein JE, Winter RB. The Milwaukee brace for the treatment of adolescent idiopathic scoliosis. A review of one thousand and twenty patients. J Bone Joint Surg Am. 1994;76:1207–1221.PubMed

31.

Moreland M. Bracing in scoliosis. Curr Opin Orthop. 1998;9:66–71.

32.

Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am. 1995;77:815–822.PubMed

33.

Nicholson GP, Ferguson-Pell MW, Smith K, Edgar M, Morley T. The objective measurement of spinal orthosis use for the treatment of adolescent idiopathic scoliosis. Spine. 2003;28:2243–2250; discussion 2250–2251.CrossRefPubMed

34.

Noonan KJ, Weinstein SL, Jacobson WC, Dolan LA. Use of the Milwaukee brace for progressive idiopathic scoliosis. J Bone Joint Surg Am. 1996;78:557–567.PubMed

35.

O’Neill PJ, Karol LA, Shindle MK, Elerson EE, BrintzenhofeSzoc KM, Katz DE, Farmer KW, Sponseller PD. Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2005;87:1069–1074.CrossRefPubMed

36.

Pehrsson K, Larsson S, Oden A, Nachemson A. Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine. 1992;17:1091–1096.PubMed

37.

Pehrsson K, Nachemson A, Olofson J, Strom K, Larsson S. Respiratory failure in scoliosis and other thoracic deformities. A survey of patients with home oxygen or ventilator therapy in Sweden. Spine. 1992;17:714–718.PubMed

38.

Picault C, deMauroy JC, Mouilleseaux B, Diana G. Natural history of idiopathic scoliosis in girls and boys. Spine. 1986;11:777–778.CrossRefPubMed

39.

Price CT, Scott DS, Reed FR Jr, Sproul JT, Riddick MF. Nighttime bracing for adolescent idiopathic scoliosis with the Charleston Bending Brace: long-term follow-up. J Pediatr Orthop. 1997;17:703–707.CrossRefPubMed

40.

Rahman T, Bowen JR, Takemitsu M, Scott C. The association between brace compliance and outcome for patients with idiopathic scoliosis. J Pediatr Orthop. 2005;25:420–422.CrossRefPubMed

41.

Refsum HE, Naess-Andresen CF, Lange JE. Pulmonary function and gas exchange at rest and exercise in adolescent girls with mild idiopathic scoliosis during treatment with Boston thoracic brace. Spine. 1990;15:420–423.CrossRefPubMed

42.

Richards BS, Bernstein RM, D’Amato CR, Thompson GH. Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine. 2005;30:2068–2075; discussion 2076–2077.CrossRefPubMed

43.

Rowe DE. The Scoliosis Research Society Brace Manual. Milwaukee, WI: Scoliosis Research Society; 1998:1–9.

44.

Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D. A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis. J Bone Joint Surg Am. 1997;79:664–674.PubMed

45.

Sanders JO. Maturity indicators in spinal deformity. J Bone Joint Surg Am. 2007;89 Suppl 1:14–20.CrossRefPubMed

46.

Sanders JO, Browne RH, Cooney TE, Finegold DN, McConnell SJ, Margraf SA. Correlates of the peak height velocity in girls with idiopathic scoliosis. Spine. 2006;31:2289–2295.CrossRefPubMed

47.

Sanders JO, Browne RH, McConnell SJ, Margraf SA, Cooney TE, Finegold DN. Maturity assessment and curve progression in girls with idiopathic scoliosis. J Bone Joint Surg Am. 2007;89:64–73.CrossRefPubMed

48.

Sevastikoglou JA, Linderholm H, Lindgren U. Effect of the Milwaukee brace on vital and ventilatory capacity of scoliotic patients. Acta Orthop Scand. 1976;47:540–545.PubMedCrossRef

49.

Shaughnessy WJ. Advances in scoliosis brace treatment for adolescent idiopathic scoliosis. Orthop Clin North Am. 2007;38:469–475.CrossRefPubMed

50.

Smyth RJ, Chapman KR, Wright TA, Crawford JS, Rebuck AS. Pulmonary function in adolescents with mild idiopathic scoliosis. Thorax. 1984;39:901–904.CrossRefPubMed

51.

Takemitsu M, Bowen JR, Rahman T, Glutting JJ, Scott CB. Compliance monitoring of brace treatment for patients with idiopathic scoliosis. Spine. 2004;29:2070–2074; discussion 2074.CrossRefPubMed

52.

Trivedi JM, Thomson JD. Results of Charleston bracing in skeletally immature patients with idiopathic scoliosis. J Pediatr Orthop. 2001;21:277–280.CrossRefPubMed

53.

Weinstein SL. Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST). Available at: www.clinicaltrials.gov. University of Iowa, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 2008. Accessed March 1, 2009.

54.

Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289:559–567.CrossRefPubMed

55.

Weinstein SL, Ponseti IV. Curve progression in idiopathic scoliosis. J Bone Joint Surg Am. 1983;65:447–455.PubMed

56.

Weinstein SL, Zavala DC, Ponseti IV. Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am. 1981;63:702–712.PubMed

57.

Wever DJ, Tonseth KA, Veldhuizen AG, Cool JC, van Horn JR. Curve progression and spinal growth in brace treated idiopathic scoliosis. Clin Orthop Relat Res. 2000;377:169–179.CrossRefPubMed

58.

Wiley JW, Thomson JD, Mitchell TM, Smith BG, Banta JV. Effectiveness of the boston brace in treatment of large curves in adolescent idiopathic scoliosis. Spine. 2000;25:2326–2332.CrossRefPubMed

59.

Yrjonen T, Ylikoski M, Schlenzka D, Poussa M. Results of brace treatment of adolescent idiopathic scoliosis in boys compared with girls: a retrospective study of 102 patients treated with the Boston brace. Eur Spine J. 2007;16:393–397.CrossRefPubMed

Title: Brace Management in Adolescent Idiopathic Scoliosis
Authors: Jonathan R. Schiller, MD
Nikhil A. Thakur, MD
Craig P. Eberson, MD
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 3/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-009-0884-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Brace Management in Adolescent Idiopathic Scoliosis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2010

Vertebral Column Resection for the Treatment of Severe Spinal Deformity

In Vivo Kinematics after a Cruciate-substituting TKA

50 Years Ago in CORR: The Management of Idiopathic Scoliosis John H. Moe MD CORR 1957;9:169–184

The Geometry of the Trochlear Groove

Sensitivity of Erythrocyte Sedimentation Rate and C-reactive Protein in Childhood Bone and Joint Infections

Orthopaedic · Radiology · Pathology Conference: Painful Palmar Mass in a 36-year-old Woman