How is scoliosis treated in adolescents with bracing?

  Idiopathic scoliosis in adolescents is a structural scoliosis deformity of the spine that occurs around the time of puberty, usually due to asymmetrical posture in the standing position or accidental detection by family members during bathing, but definitive confirmation requires a full spine X-ray in the standing position.  Currently, a Cobb angle of 10° is commonly used as the minimum criterion for the diagnosis of scoliosis, and it has been reported that 2 to 3% of adolescents aged 10 to 16 years have scoliosis of 10° or more, but the prevalence decreases as the Cobb angle increases.  Brace therapy, an important treatment for adolescent idiopathic scoliosis, is often suitable for mild scoliosis with a curvature of 20o to 45o. For patients with scoliosis greater than 45o, surgery is often required.  A variety of clinical braces are available for the treatment of scoliosis, which must be appropriately designed for the specific scoliosis curve. Thoracic scoliosis with a parietal vertebra at T7 or above requires a Milwaukee brace or an upper structural Boston brace, whereas simple lumbar or thoracolumbar scoliosis does not require a Milwaukee brace and is better treated with a properly designed TLSO.  All braces are designed to stop the aggravation of scoliosis during adolescent growth, and the brace acts as a lateral spinal support to stop the progression of scoliosis during a period of rapid spinal skeletal growth. Bracing is effective in stopping progression of the deformity in a high percentage of skeletally immature adolescent patients.  Considerations for brace therapy: 1. Scoliosis found in the adult years with a maximum degree of less than 45 degrees.  2. Strictly follow the doctor’s recommendations for bracing. The longer the brace is often worn daily, the better the orthopedic effect.  3, regular check-ups to clarify the changes and progress of scoliosis.  4, with the growth of the spine, the need to replace the appropriate brace in a timely manner, the appropriate brace is very important to stop the growth of the spine.  5, the success of brace treatment is closely related to the patient’s compliance and family cooperation in wearing the brace.