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It should come to no surprise to anyone to a reads more than 2-3 threads on this site that I do not support the use of artificial correction in the form of scoliosis brace treatment in adolescent idiopathic scoliosis (AIS). However, I don’t believe I have ever stated my case against brace related treatment in AIS from start to finish and I’m not sure that is even possible in the confines of the forum limitations or electronic communication…..but that won’t stop me from trying.

Process + Application = Results

Process: The thought process of scoliosis brace application is a fundamentally flawed process in the regard to treating scoliosis primarily as a spinal condition, rather than “primarily as a neurological condition with its primary effects on the spine”. This simple adaptation in the thought process (scoliosis is primarily a neurological condition, rather than a spinal one) creates a change in the treatment paradox that is self-evident and makes the current treatment thought process obsolete almost immediately. I mean, would anyone really elect to treat a neurological condition like a spinal condition on purpose?
The evidence for this change in thought process is growing too. Virtually every single accepted theory on the origin of AIS cites a “yet-to-discovered” neurological origin and various other types of scoliosis are known to be caused by neurological disorders (polio, cerebral palsy, Arnold-Chiari syndrome, ect.)

http://www.fixscoliosis.com/threads/...essive-factors

Application: Application sort of becomes a moot point once it is realized that the scoliosis brace treatment is being mis-focused on the symptom of the condition (the spinal curvature) rather than the primary neurological cause, but there are some note worthy bio-mechanical short falls in the application of scoliosis brace treatment that need to be addressed….namely head and neck position.
The head and spine are oriented in 3 dimensional space via the righting reflexes of which the eyes, inner-ear, and stretch receptors in the cervical spine provide the majority of the input into the hind brain which in turn coordinates the body’s muscular contraction and aligns the spine to gravity for optimal form and function under the force of gravity.

The artificial correction of the brace completely ignores the 3 major inputs of the neurological righting mechanisms, creates further muscular dis-coordination via brace dependency, and causes inter-segmental immobilization (thus converting a functional (fixable) curvature into a structural (non-fixable) curve and could promote the very collagen kinking that causes IVD wedge deformity (a key aspect of curve progression).

Results: Forms of scoliosis brace treatment for scoliosis can be traced back to as early as 5th century AD and the first metal scoliosis brace was constructed almost 500 years ago (1575) by Ambrose Pare. In all that time and experimentation no one has been able to demonstrate consistent results with any scoliosis brace treatment protocols regardless of process or application of the brace. In fact, the most positive research review could only find "There was very low quality evidence from one prospective cohort study with 286 girls that a brace curbed curve progression at the end of growth better than observation (aka: doing nothing) and electrical stimulation.” And that is the good news results?

The bad news results are significantly more damning…..especially the oral presentation done by the Axial Bio-Tech company (developers of the Scoliscore test) at clearly demonstrated that bracing has absolutely no effect on the natural course of the condition (http://www.scoliosisjournal.com/content/4/S2/O59) and a 2007 article in the SPINE journal by Weinstein and Dorlan concluding “that observation only or bracing showed no clear advantage of either approach. Furthermore one can not recommend one approach over another to prevent surgery. They gave the recommendation for bracing a grade "D" relative to observation only because of "troublingly inconsistent or inconclusive studies on any level." I suspect the upcoming BrAIST study will conclude more of the same.

Conclusion: It is time to recognize that we cannot manipulate the application portion of the equation any further and expect a successful result. Only when we summon the courage to re-visit the process of how we actually view and treat this condition will we begin to achieve consistent results and begin to alter the natural course of the condition…..and then and only then will the scoliosis surgery rates begin to drop.