When an adolescent child has moderate scoliosis, or a spinal curvature of 20-40 degrees, bracing the back can prevent the scoliosis from worsening to the point of requiring surgery. When worn 18-20 hours a day, these custom-fit back braces increase the chance of avoiding surgery by nearly a third.
View Child-Friendly ExplanationIf your spine has a little curvature in it and you still have a lot of growing left, your doctor might ask you to wear a brace. This is like wearing a stiff jacket under your clothes to keep your spine straight as you grow.
Pediatric Orthopedic doctor
What is a Back Brace
What is a Back Brace
Once your child’s spinal curvature reaches 25 degrees, and if your child still has significant growth left, physicians may recommend a scoliosis brace to hold the spine in place externally and prevent the curvature from worsening as your child grows. The most commonly used back brace is a thoracic-lumbar-sacral-orthosis (TLSO), which is a plastic shell that fits underneath your child’s clothing and runs from the armpits to just above the hips.
If your child has a severe curvature, bracing may be used to keep the scoliosis from progressing until the child is old enough for surgery. However, one in three spinal surgeries can be prevented through appropriate use of scoliosis braces.
How Does a Back Brace Work
How Does a Back Brace Work
When we are able to detect scoliosis early enough, the brace can be worn throughout your child’s growth spurt to prevent the spine’s curvature from growing large enough to require surgery. The back brace is worn for 18-20 hours a day and typically removed only for bathing and swimming, though it can also be removed for other, brief occasions like sporting events and practices. Braces are custom fit and easily worn – unnoticeably – under clothing. Patients have no activity restrictions in the braces, which are worn until a patient is done growing. On average this is:
- 14 years of age for girls
- 16 years of age for boys
When your child is ready to be fitted for a customized back brace, you will be referred to an orthotist who will mold the brace to your child’s measurements. Once the brace is made, your child will return to the physician’s office for a fitting and adjustments. These custom-fit braces should not irritate or cause discomfort. If that occurs, the doctor will suggest adjustments to be made by your brace maker (orthoptist).
After two weeks of wearing the brace, your child will return to the physician to have X-rays taken while wearing the brace. Riley at IU Health physicians use EOS imaging, a special 3-D, low-dose radiation system designed for repeated scoliosis monitoring. If the brace is correcting the spinal curvature, it’s considered to be a well-fitting brace. If the physician doesn’t see enough of a correction, he or she will make more adjustments. Ultimately, the goal is to keep your child’s spinal curvature from worsening as your child grows to adult height.
Key Points to Remember
Key Points to Remember
- Early detection of scoliosis is critical in order to achieve the best results from bracing.
- Compliance in wearing the brace is very important. To achieve the maximum benefit, the brace should be worn 18-20 hours a day.
- The goal of bracing is to prevent surgery by keeping the spinal curvature under 50 degrees for the upper spine and under 40-45 degrees for the lower spine. One in three surgeries can be prevented with this treatment.