Brace Prevents Curve Progression in Scoliosis

Boston brace worn more than 12 hours a day effective in adolescent idiopathic scoliosis
By Beth Gilbert
HealthDay Reporter

FRIDAY, June 11 (HealthDay News) -- The use of a Boston brace for more than 12 hours daily in patients with adolescent idiopathic scoliosis is effective in controlling curve progression, according to a prospective study published in the June 1 issue of the Journal of Bone & Joint Surgery.

Donald E. Katz, of the Texas Scottish Rite Hospital for Children in Dallas, and colleagues evaluated 100 patients with adolescent idiopathic scoliosis curves measuring between 25 and 45 degrees who were managed with a back brace prescribed for 16 or 23 hours. A Boston brace fitted with a heat sensor that measured the exact number of hours the brace was worn was used in the study.

The researchers found that the lack of curve progression was associated with the total number of hours the brace was worn, with the effect most significant in patients at Risser stage 0 or 1 when starting treatment, and in those with an open triradiate cartilage at treatment onset. Logistic regression analyses showed a dose-response effect, in which the greater the number of hours the brace was worn correlated with lack of curve progression. In addition, 82 percent of adolescents who wore the brace for more than 12 hours per day did not show curve progression, compared to 31 percent who wore the brace for less than seven hours daily.

"The less-mature patients (Risser 0 and 1), who are the most likely to have curve progression, showed the strongest treatment effect in comparison with the more-mature patients (Risser 2)," the authors write. "We believe that these findings refute the null hypothesis that brace wear does not influence the progression of scoliosis."

One or more of the authors disclosed financial ties to Medtronic and W.B. Saunders.

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