Time and time again, parents sit across from me in my office describing the gut wrenching experience they endured during their child’s first brace fitting. Watching their child melt down in tears, complain about not being able to breath, and seeing the panic in their eyes when the doctor tells them they have to wear it 23 hours a day for the next 2-3 years. I also feel a sense of how disturbed these parents felt at that very moment, because they almost always seem to be looking straight through me as they tell the story.
Bracing is a relic and remaining product of the growing gap in treating the scoliosis condition. The clinical application of bracing simply isn’t accurately reflecting the ever growing body of knowledge regarding adolescent idiopathic scoliosis. In short, the continued use of scoliosis braces in most cases is a result of the growing gap between what we know about idiopathic scoliosis and how we treat idiopathic scoliosis.
This growing gap is one of the driving motivations behind ScoliSMART’s efforts to “find a better way” treat scoliosis. The ScoliSMART approach to treating scoliosis is more effective than bracing, because it can actually reduce the spinal curvature, keeps kids involved in their social and activities, and doesn’t torcher your child in the process.
The ScoliSMART approach is better than bracing
The doctors of ScoliSMART published their first “end-of-growth and skeletal maturity” success rate study in January of 2017. Basically, the retrospective study included patients who started the ScoliSMART program only at Risser 0-1 and reached skeletal maturity (Risser 5) with the curvature LESS than 50° (surgical fusion threshold). The results were remarkable. While the Bracing Adolescent Idiopathic Scoliosis Treatment study published in 2014 boasted a 72% success rate after 2 years of data collection, it did not account for the 27% of patients who dropped out of treatment during that time. Thus artificially elevating the success rate. In contract, the ScoliSMART success rate was an incredible 97.3% over a 2.5 year period with only a 13% patient dropout rate. Both studies were conducted under Scoliosis Research Society guidelines, thus making the result comparable. The statistical data favored the ScoliSMART approach over scoliosis bracing in success rate and patient dropout over a longer period of time.
Full time bracing is intolerable for most kids
Thankfully, most of us have never had the “pleasure” of being fitted or actually having to wear a rigid scoliosis brace (most often named after a city like Boston, Milwaukee, Charleston, ect). The sear thought of being forced to wear something that severely restricted my motion, breathing, and any type of physical activities the patient may have once enjoyed. Part of the irony is full time rigid bracing can actually decrease breathing capacity (one of the most concerning aspects of severe scoliosis) as much as 30%, which are levels often seen in populations of chronic smokers! Also, advanced imaging of patients in brace vs out of brace indicate the pressure on the rib cage will actually increase the rib cage deformity and make the rib hump worse as well! In fact, I had an “off the record” conversation with a top Orthopedic scoliosis specialist and he said he always resists parents requesting braces, because “the kids just “wilt” away emotionally, physically, and psychologically”.
ScoliSMART keeps you child doing what they love
As parents, we all want our children to one day be able to reflect back on the memories they created during their childhood fondly. We fully understand the freedom of childhood is a unique time when kids can pursue dreams and activities without consequences or responsibilities of adulthood. Unfortunately, perhaps the cruelest aspect of full time bracing is how it robs children of the opportunity to make those valuable, lifelong memories. There is basically no way kids can fully engage in cheerleading, gymnastics, basketball, swimming, or almost any other active lifestyle with a bulky hard plastic brace restricting their torso. The detriment of full time bracing on a teen’s social life goes without saying.
Teens with scoliosis utilizing the ScoliSMART approach to treatment have little or no restrictions on their social or physical activities during the treatment sessions and even the period of home rehabilitation after the in-office treatment protocols. We firmly believe the memories kids make at this age are valuable and should be considered when making treatment decisions.
Full time rigid bracing is a relic of our past assumptions about idiopathic scoliosis and its treatment. The clinical data suggests it is less effective than other non-invasive approaches that are more in line with the current body of knowledge concerning idiopathic scoliosis. These more updated scoliosis exercise approaches have a higher level of patient satisfaction and compliance, while maintaining the patient’s activity and social quality of life throughout the treatment process.