Scoliosis Bracing: Details Make the Difference Current Concept Review

Abstract

Effective bracing for idiopathic scoliosis is influenced by factors such as age, skeletal maturity, and curve attributes, with success reliant on patient adherence and engagement. The BrAIST study highlights the merits of full-time bracing (16-23 hours/day) for most curves, though part-time wear, yielding around 70% curve correction, may be suitable for smaller curves. Maintaining communication among the orthopedic surgeon, orthotist, and patient is paramount. Using standardized, effective communication detailing patient data, including radiographic measurements, supports clear communication between all parties. Consistent orthotist visits are important to ensure correct brace fit by evaluating aspects like tightness, comfort, and deformity correction. Monitoring growth metrics like height and weight can signal necessary adjustments. An initial in-brace x-ray facilitates early refinements, with subsequent imaging based on growth stages and brace adherence. Adherence monitors augment treatment by tracking brace-wear patterns. Weaning protocols, aiming to reduce brace wear gradually while curbing curve progression, are influenced by factors such as curve size, brace comfort and skeletal maturity markers. Lastly, psychological aspects cannot be overlooked. Overcoming barriers like physical discomfort and self-consciousness is pivotal for effective treatment. Emphasizing resilience, choice, and emotional support ensures enhanced patient commitment and satisfaction, leading to the best possible outcomes.