Scoliosis Research Society (SRS)
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
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SRS Position Statement

Insurance Reimbursement for Spinal Orthosis Used in the Treatment of Idiopathic Scoliosis

Brace treatment for idiopathic scoliosis in growing children is an established non-surgical method for reducing the risk of scoliosis progression1-6. Based upon current evidence it is the opinion of the Scoliosis Research Society that bracing reduces the incidence of surgery for scoliosis.

Studies of bracing efficacy have demonstrated that patients who do not wear braces are 3-4 times more likely to require spinal fusion surgery than similar groups of braced patients.2,3 Third party payers should note that bracing for scoliosis is used for prevention of progressive, disabling deformity. Bracing is frequently a medically necessary component of the treatment of scoliosis. Spinal orthoses for scoliosis should not be considered "durable medical equipment" similar to wheelchairs, handrails, hospital beds and other items that may assist in the performance of normal activities of daily living. Third party payers should recognize that bracing for scoliosis is cost effective since it can reduce the need for expensive surgical intervention.

Furthermore, multiple spinal orthoses may be required during the period of growth when scoliosis requires treatment. Restrictions on the number of braces in a year or over several years may have a detrimental effect on the end result of non-operative management for idiopathic scoliosis.

It is in the best interests of patients and also cost-effective for third party payers to provide reimbursement for spinal orthoses when prescribed by the treating physician for the management of idiopathic scoliosis.

References

  1. Allington NJ, Bowen JR. Adolescent idiopathic scoliosis: treatment with the Wilmington brace. A comparison of full-time and part-time use. JBJS July 1996;78-A(7): 1056-62
  2. Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME. The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine 1986; 11:792-801.
  3. Fernandez-Feliberti R, Flynn J, Ramirez N, Trautmann M, Alegria M. Effectiveness of TLSO bracing in the conservative treatment of idiopathic scoliosis. JPO 1995; 15(2):176-181
  4. Price CT, Scott DS, Reed FR, Jr., Sproul JT, Riddick MF. Nighttime bracing for adolescent idiopathic scoliosis with the Charleston Bending Brace: long-term follow-up. JPO 1997; 17(6):703-707
  5. Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D. A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis. JBJS 1995; 77-A(5):664-674
  6. Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. JBJS 1995; 77-A(6):815-822