Researchers at Texas Scottish Rite Hospital for Children, Dallas, have demonstrated a strong correlation between brace wear and the progression of scoliosis curvature.
A team led by Donald Katz, CO, FAAOP, fitted 126 patients who had adolescent idiopathic scoliosis with a Boston Brace. The brace was outfitted with a heat sensor to detect actual, versus patient-reported, wear times. The patients, whose curvatures all initially fell within 25-45 degrees, were prescribed either 16 or 23 hours of daily brace wear, and the research team was blinded to the wear data. One hundred of the patients completed the study, and at the study’s conclusion, researchers compared the number of hours of actual brace wear to the frequency of curve progression beyond six degrees and to curve progressions that required surgery.
Katz’s team reported in the June Journal of Bone and Joint Surgery that the total number of hours of brace wear correlated inversely with the patients’ risk of curve progression, most dramatically in patients who were initially diagnosed at Risser stage 0 or 1 or as having an open triradiate cartilage. Eighteen percent of patients who wore the brace more than 12 hours per day experienced curve progression, while 69 percent of those who wore the brace fewer than seven hours per day did. Of patients who wore the brace 16 hours per day or more, only 17 percent experienced curve progression; however, none of them needed surgery. Hours of brace wear also correlated inversely with the need for surgery overall, and patients who wore their braces to school and immediately afterward were the most successful in halting their curve progression.
“Frankly, this is very reassuring to us that we can be reasonable in our approach,” Katz told WFAA, a Dallas/Fort Worth television station. “You can get by with basically asking a child to wear [the brace] 16 hours a day.”