My 11-year old daughter has scoliosis severe enough to wear a brace. If she is faithful to wear it, can she avoid having surgery later on?

Simply stated, no one knows the answer to this question. The reason is because it's not considered ethical to treat one group of children with bracing and compare them to a similar group without bracing. Not bracing a child with scoliosis is the same as withholding treatment. It's just not done in this country.

A recent expert panel on this topic was surveyed on the effectiveness of bracing. Today's protocol suggests bracing should be done when a curve is 45 degrees or more. But when presented with 12 case studies to decide treatment on, there was a wide range of opinion among the panel. Some thought bracing would be very helpful. Others said it would be no use at all.

Studies on the outcomes of surgery after bracing don't have clear results either. Results of these studies do not support bracing as being better than just observation.

What's needed is a study that compares children with and without bracing. Up until now, that kind of study has been considered unethical. The reason is that not bracing a group is the same as withholding treatment. But the problem is, no one knows for sure that bracing really helps prevent a worsening of the problem. So how can it be unethical to withhold a questionable treatment?

We may see a comparative study sometime in the near future. Until then, many surgeons and parents agree to use bracing as a "just in case" measure. It may or may not prevent surgery later.

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