Bracing for Impact – Bracing in Adolescent Idiopathic Scoliosis

Abstract

Bracing plays a vital role in the non-operative treatment of adolescent idiopathic scoliosis (AIS), especially when detected early. Recent high-quality studies confirm that bracing can alter the natural progression of a curve, potentially preventing the need for surgery. The concept is based on the ability of external force to guide spine growth, which has been experimentally proven. However, bracing cannot straighten the spine; its primary goal is to halt the curve’s progression. The evidence for bracing is strong, with studies showing that approximately two-thirds of AIS curves can be controlled through bracing. However, there are concerns about the broad application of bracing indications, potentially leading to unnecessary treatment for some patients. Identifying the 25% of patients who will benefit from bracing remains a challenge. Bracing is most effective when applied to curves between 25-45° during the rapid growth phase, but compliance is crucial for success. The choice of brace type matters less than its quality and corrective effect. The practice of bracing requires a close orthotist-surgeon relationship, and follow-up visits are essential to monitor progress. Ultimately, bracing remains a valuable non-surgical option for AIS, but careful patient selection and close monitoring are necessary for optimal results. Keywords: Brace, Adolescent idiopathic scoliosis.