Bracing the Unbraceable: Boston Brace Shows Positive Results for Large Curves of ScoliosisThe Boston brace has been shown to help people with scoliosis when their spinal curve is less than 30 degrees. But most experts have felt the brace couldn't keep curves over 35 degrees from getting worse. There is agreement that surgery should be held off until the curve reaches 40 degrees, which poses a dilemma when the curve is between 35 and 40 degrees. These curves are too small for surgery and too big to be helped by a brace.
The authors questioned whether the Boston brace could halt curves that were over 35 degrees. They also questioned if the amount of time the brace was worn each day mattered. The study included 45 girls and 5 boys averaging 13 years old. Each patient was prescribed the Boston brace to treat spine curves of 35 degrees or more. They were told to wear the brace 23 hours each day. They had appointments every four to six months to check their spine curves and to see how many hours they actually were actually wearing their braces. When they reached spinal maturity, they gradually stopped using the brace.
Results were compared an average of two years after skeletal maturity and again about 10 years later. By looking back at the patients' records, the authors found that the Boston brace was effective in preventing large curves from getting worse. This was especially true when patients actually wore their brace for the recommended amount of time each day.
Those who wore their brace for more than 18 hours each day had the best results. Their curves actually improved by about 12% from the time they started using the brace. Those wearing the brace less than 12 hours per day showed an increase of almost 14% in the size of their curves.
The conclusions are clear. The Boston brace can help keep large curves from getting worse in patients with scoliosis, especially when it is worn 18 or more hours per day.
Jeffrey W. Wiley, MD, et al. Effectiveness of the Boston Brace in Treatment of Large Curves in Adolescent Idiopathic Scoliosis. In Spine. September 15, 2000. Vol. 25. No. 18. Pp. 2326-2332.
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