Bracing ‘effective in reducing adolescent scoliosis’

Scientists say that the use of bracing in adolescents suffering from idiopathic scoliosis may reduce the risk of the condition progressing to the point that surgery is needed.

Scoliosis is a condition in which the spine abnormally curves to the right or left. When it occurrs in a child or teen, the condition is referred to as adolescent idiopathic scoliosis (AIS).

It is unknown what causes the disorder, but severe cases of the condition, if untreated, may cause pain and disability, particularly if a child is still growing.

According to the National Scoliosis Foundation, scoliosis affects approximately 6 million people of all age groups in the US. There is no cure for the disorder, but bracing is the usual treatment for children and adolescents with a spine curvature of between 25-40 degrees.

However, the researchers say that while this is the preferred treatment for AIS, evidence regarding its impact has been inconclusive.

For the study, published in The New England Journal of Medicine, researchers from the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) wanted to compare the risk of curve progression in adolescents with AIS who wore a brace, and those who did not.

The study was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health.

The research team analyzed 242 patients aged 10-15-years, from 25 institutions in the US and Canada between 2007 and 2011. Patients were recruited who were at high risk for continued worsening of their curved spines, based on their age, skeletal immaturity and the severity of their curvature.

The study originally began as a randomized study, the researchers say, but they later added a “preference cohort,” meaning that the patients and their families were able to choose their own treatments.

From the 242 patients incorporated, 116 were at random designated either to bracing or observation – where they received no specific treatment. Another 126 chose between bracing and observation.

Patients within the bracing group were needed to put on them 18 hrs each day. The scientists defined the therapy as not successful whenever a patient’s curve advanced to 50 levels or even more.

This can be a time surgical treatment is usually suggested. If your child arrived at “skeletal maturity” having a spine curve under 50 levels, the therapy was classed as effective.

Bracing ‘significantly reduces progression of AIS’

The scientists state that in The month of january 2013, the trial was stopped early because of the signifiant success the braces had on reducing the chance of curve progression and the requirement for surgery.

Of patients who wore braces, 72% were defined as having successful treatment. Furthermore, it was found that the more hours the patients wore the braces, the better the success rate. Wearing a brace for more than an average of 13 hours a day was linked to a 90-93% success rate.

Stuart Weinstein, of the University of Iowa and lead study author, says:

“This study presents important evidence addressing the fundamental question facing families and clinicians dealing with the diagnosis of AIS – to brace or not to brace. Now we can say with confidence that bracing prevents the need for surgery.”

The scientists also are convinced that 48% of patients within the observation group demonstrated effective outcomes, in addition to 41% of patients within the bracing group who used the braces rarely.

The research authors observe that, as others have recommended, current bracing signs might be too broad, leading to unnecessary strategy to many patients.

They add:

“You should identify patients at high-risk for scientifically significant curve progression who’re also probably to profit from bracing.”

This past year, Medical News Today reported research that demonstrated how magnetically controlled growing rods might be effective in dealing with scoliosis in youngsters.