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Effectiveness of Braces in Mild Idiopathic Scoliosis

MILLER, J. A. A.*; NACHEMSON, A. L.; SCHULTZ, A. B.*

1984 Volvo Award in Basic Science: PDF Only
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Despite the wide use of bracing for the treatment of idiopathic scollosis, controlled studies apparently have not been performed to examine whether bracing, in fact, alters the natural history of spine lateral curves. We studied 255 female patients, ages 8–17 years, with idiopathic scoliosis who had curves with initial Cobb measures from 15–30°. They were divided into two groups: one group consisted of 144 patients who had received a Milwaukee or Boston brace; and the other, a control group, consisted of 111 patients who remained untreated through a mean period of 1.9 years. The groups had similar mean ages, ages of menarche and curve severities. The results showed a slight but nonsignificant trend, suggesting that bracing reduced the overall probability of progression in the braced curves. However, noting that nearly 75% of the control group curves were nonprogressive, It is possible that a similar proportion of the braced curves need not have been braced. Moreover, bracing falled to prevent eight curves in seven patients (5%) from progressing. These curves progressed at a mean rate of 8° per year. Our retrospective results suggest that bracing probably is not necessary in a large proportion of patients who meet current, clinical criteria for bracing. Given the limitations of retrospective studies like this one, a controlled prospective trial of bracing effectiveness in idiopathic scoliosis seems warranted.

*Department of Mechanical Engineering and Applied Mechanics, University of Michigan, Ann Arbor, Michigan

Department of Orthopaedic Surgery 1, Sahlgren Hospital, University of Göteborg, Sweden.

© Lippincott-Raven Publishers.