Can idiopathic scoliosis (IS) be improved through bracing? That is a question that has been studied and debated for years. There are plenty of studies that conclude it is not possible, especially when the curve is more than 45 degrees in a growing child. But the results of this study may bring new information to that conclusion.
Idiopathic scoliosis refers to a curvature of the spine that has no known cause. The child does not have a neurologic or neuromuscular problem like muscular dystrophy or cerebral palsy that could account for this problem. Treatment in the past with bracing and exercises just hasn’t been effective in large curves.
But the results of this new study from Italy show that in some children, the curve can be stopped and even improved with bracing and exercises. They claim the difference is in patient compliance (willingness to follow a strict program) and the use of good bracing. Oh yes, and time — the program of bracing and exercise was followed for years (three to seven).
The study was small in number (28 children) and all were skeletally immature (still growing). At age 16, you may still have some growth left (if you are a boy). Most girls have completed their full growth potential by this time.
The children in the Italian study were told to wear the brace everyday, all day (at least 23 hours/day) for a full year. After six months, the child could reduce his or her brace wearing time by two hours. And every six months after that, the brace wearing time could be decreased by two more hours until the child was weaned from the brace altogether.
At the same time, physical therapists helped the children with postural and stabilization exercises. This type of rehab program helps retrain motor control of the muscles. The goal was to maintain the correction received with the brace during and after the weaning time.
The idea behind this bracing/exercise/weaning program is that the slow method allows the postural system to adapt. The intended results are improvement of the curve and maintenance of any spinal correction achieved.
We can’t really generalize from this study and say that bracing for scoliosis is effective for large curves. If you are wearing a brace but still progressing, there are several things you can check on.
First, is the brace still fitting and is it the best possible brace for you? There are several types to choose from. Second, are you still growing (an X-ray will give your surgeon the answer to this question). Third, are you wearing the brace as prescribed? Are you doing your exercises correctly and consistently? Failure to follow the program as prescribed may be a key factor in the success or failure of a conservative approach to this problem.