Bracing Reduces Worsening of Adolescent Idiopathic Scoliosis

According to a recent study published in the New England Journal of Medicine, bracing in adolescents with idiopathic scoliosis reduces the likelihood that the condition will progress to the point of requiring surgery.

With mild cases of adolescent idiopathic scoliosis (AIS), physician monitoring may be all that is needed. More severe cases may require the use of a brace or even surgery, especially when the child is still growing. 

RELATED: Musculoskeletal Disorders Resource Center

Regarding the use of a brace, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Director Stephen I. Katz, MD, PhD stated that “its impact has been inconclusive.”

The Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) was designed to compare the risk of curve progression in adolescents with AIS who wore a brace with those who did not. A total of 383 patients were recruited between March 2007 and February 2011 who were at high risk for continued worsening of their spinal curves. 

The study began as a randomized study, but the team added a preference cohort, where patients and families were able to choose their own treatment. Treatment was randomized for about 40% of study participants and based on preference for the remainder.

Patients in the bracing arm wore a brace for 18 hours a day. Unsuccessful treatment was defined as a curve progressing to >50 degrees – a point at which surgery is typically recommended. Successful treatment was defined as a child reaching skeletal maturity without this degree of curve progression.  

In the randomized and preference arms, 72% in the bracing group achieved success. Study results showed that wearing a brace for >13 hours a day was associated with success rates of 90–93%. Patients who wore the brace infrequently (48% of observation group, 41% of bracing group) still had positive outcomes.

The BRAIST was stopped in January 2013 after concluding that bracing significantly reduced the risk of curve progression and the need for surgery. Study authors also concluded that more hours of brace wear correlated to higher success rates.

For more information call (877) 226-4267 or visit the NIAMS website.

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