Scoliosis Research Society (SRS)
An International Organization Dedicated to the Education, Research and Treatment of Spinal Deformity
Our Mission is to Foster Optimal Care for All Patients with Spinal Deformities
If the curve is progressive, and your child is still growing, your surgeon may want to place your child in a brace. This depends on the flexibility of the curve, as determined by the bending X-rays. If the curve is rigid and does not correct (get smaller) on the bending X-rays, a brace will do little good. Rarely does a brace permanently correct scoliosis, instead the goal of bracing is to allow the child to grow before a surgical procedure is done. It must be re-emphasized that the purpose of the brace is to slow the inevitable progression of the curve, not to correct the curve.
The brace that your doctor prescribes may depend on your child's age and the center you visit. There are several types of braces that have the same success rates, but your doctor will select one based on his/her experience with the different devices. The Kalabas brace has several straps that are applied over the shoulder and bend the child in the opposite direction of the curve (Figure 1). The Wilmington brace is a custom-molded thoracolumbosacral orthosis that has molds to push and correct the curve (Figure 2). The Boston brace is similar, but uses pads inside the brace to push the curve (Figure 3). The Milwaukee brace, one of the first braces developed for scoliosis, is also similar, but includes an extension to the chin (Figure 4). It is the only brace, however, that can manage curves in the top part of the spine. Your doctor will probably recommend that your child wear the brace full-time. Braces are generally removed for bathing and special occasions. As your child grows, new braces will need to be fabricated, approximately every twelve to eighteen months.
Braces may not be effective in every child for various reasons. The curve may be stiff and resistant to correction. Braces also have a more difficult time controlling kyphosis (rounded back) and lordosis (sway back). Since most braces work on the curve by putting pressure on the rib cage, concern exists over the effect that the brace has on the rib cage and the subsequent development of the lungs.
Figure 1 - The Kalabas brace has several straps that are applied over the shoulder and bend the child in the opposite direction of the curve
Figure 2 - The Wilmington brace is a custom-molded thoracolumbosacral orthosis that has molds to push and correct the curve.
Figure 3 - Boston brace or thoracolumbar sacral orthosis (TLSO)
Figure 4 - The Milwaukee brace, with an extension to the chin, is able to control curves in the top part of the spine.