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The evidence and studies are proving time and time again that back bracing for scoliosis has no effect on the curvature or natural progression of the condition. This study even compared the results of bracing vs. the genetic testing predicted outcomes. The results clearly show that bracing for scoliosis provides no benefit to the patient.
Does bracing alter the natural history of Adolescent Idiopathic Scoliosis?
J Ogilvie , L Nelson, R Chettier and K Ward
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
author email corresponding author email
from 6th International Conference on Conservative Management of Spinal Deformities
Lyon, France. 21-23 May 2009
Scoliosis 2009, 4(Suppl 2):O59doi:10.1186/1748-7161-4-S2-O59
The electronic version of this abstract is the complete one and can be found online at: http://www.scoliosisjournal.com/content/4/S2/O59
Published: 14 December 2009
© 2009 Ogilvie et al; licensee BioMed Central Ltd.
Background
Orthotic treatment of children with AIS is a generally accepted treatment option. Failure of bracing to halt curve progression has been reported in 20% or more of patients, and it is known that some curves in children with AIS will not progress even if untreated. Success and failure rates of brace treatment vary considerably.
Purpose
We reviewed the response to brace treatment in patients who were also analyzed with a DNA-based adolescent idiopathic scoliosis progression test (AIS-PT) and compared this with the natural history of adolescent idiopathic scoliosis without treatment. Our purpose was to document the influence of orthotic care on the outcome at skeletal maturity.
Methods
Medical records and x-rays were reviewed, and DNA was collected with a saliva sample in two cohorts of Caucasian female AIS patients. A risk of progression score was calculated using 53 genetic markers with utility for calculating the risk of AIS curve progression from < 25° to > 40° before skeletal maturity or > 50° at maturity (1-200). Group A (2442 females) had no brace treatment and their outcome at maturity or surgery was known. Group B (308 females) were brace compliant for more than one year and their curve severity at maturity or surgery was known.
Results
There was little statistical difference in the curves representing risk of progression versus curve severity when the two groups were compared.
Conclusion
In this retrospective study of US Caucasian females, there was no statistically significant difference in the natural history of adolescent idiopathic scoliosis when comparing bracing treatment and no bracing treatment. At best, there was only a modest brace effect. Prospective trials with genotype homogeneity are needed to validate current assumptions about the efficacy of orthotic types and treatment regimens when bracing adolescent idiopathic scoliosis.