Spinal Bracing: A Treatment Option for Scoliosis in Children

Kids may need to wear a brace to stop the spinal curve

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Spinal bracing is a common nonsurgical treatment for children with scoliosis. The overarching goal is not to permanently correct scoliosis, but rather to stop or slow the progression of the curve—and bracing can be quite effective to that end.

A 2013 study on brace treatment for adolescent idiopathic scoliosis published in The New England Journal of Medicine found that 75% of the brace-wearing patient sample had treatment success. The authors concluded that bracing “significantly decreased the progression of high-risk curves to the threshold for surgery.”

doctor with parent and child

When Spinal Bracing is Recommended
With mild or moderate curves, or with curves that are likely to progress, bracing is a terrific nonsurgical treatment to prevent the curve from worsening. While a brace can help stop the curve from progressing, it generally won't fix the curve that's already there.

Before prescribing bracing, your doctor will consider the flexibility of the abnormal curve. If the curve is rigid, which your doctor will see on bending or traction x-rays, a brace will likely not be recommended.

Other things your doctor will consider with spinal bracing include:

  • How much growing the child has remaining
  • The location of the curve (a curve in the mid-back (thoracic spine) is much more likely to worsen than a low back (lumbar spine) curve)
  • The severity of the curve
  • How the curve is affecting the child's life
  • How likely it is that the curve will progress (if the curve is already severe and the child hasn't gone through the adolescent growth spurt, it will most likely get worse when he or she grows)

Bracing is the typical treatment for children with curves between 25-degrees and 45-degrees and at least two years of growth remaining. Ultimately, the goal is to stop the progression of the curve and avoid a spinal fusion surgery.

Types of Scoliosis Braces
While many types of spinal braces are available today, they generally fall into two categories: plastic braces (also called rigid braces) and soft elastic braces (also called dynamic braces).

Your doctor will work with an orthotist to craft a custom brace for the child. When deciding the optimal brace, your doctor will consider all the key details of the curve (the location, flexibility level, and number of curves), along with any other medical conditions the child has.

Tips for Wearing a Brace
Wearing a brace is a big commitment, one that parents and children need to work on together. Here are some key points to remember if you want bracing to be as effective as possible:

  • Just what the doctor ordered: Your doctor will decide what type of brace is best for the child's curve, and how long he or she should wear it every day. Some children must wear their brace up to 23 hours a day. While that may be intimidating, it's crucial that the child wear the brace for the full time. Your doctor will work with you to determine when the child doesn't have to wear his or her brace. For example, if he or she likes swimming, your doctor may arrange the brace schedule to accommodate swim team practices.
  • Wear it well: The child may be in and out of the brace a few times each day. It's important that the brace is tight enough and properly positioned every time it’s put back on. If it isn't, it won't do as much good.
  • Watch what you wear: Underneath the brace, the child should wear a shirt that fits well and doesn't wrinkle. This will help protect his or her skin because it can get irritated from the brace. Over the brace, the child can wear normal clothes, although you might have to buy clothes a size or two bigger to fit over the brace.

Spinal bracing for scoliosis can be both physically and emotionally uncomfortable. At a time when kids want to fit in with their peers, a brace may be a noticeable difference. Fortunately, technology has advanced over the years to bring better, less noticeable braces to the market. Plus, with support from family, friends, and medical professionals, kids get through it just fine—and usually with a healthier back at the end of it!

 

Updated on: 02/03/17
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Surgery for Scoliosis
Mary Rodts, DNP
This article was reviewed by Mary Rodts, DNP, CNP, ONC, FAAN.
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