Scoliosis braces are torso-conforming apparatuses – most commonly made of plastic or metal – intended to prevent further curvature of the spine among scoliosis patients whose bones have not yet reached maturity. A wide range of scoliosis braces exists. While the appropriate bracing option depends on the location and severity of the individual's spinal curve, braces are generally prescribed for patients whose degree of curvature falls between 20 and 40 percent.
Conceived by Drs. Albert Schmidt and Walter Blount in 1945, the Milwaukee Brace is one of the oldest scoliosis braces. This type of brace, usually prescribed for curvature in the upper spine, consists of a pelvis-encircling plastic corset and a neck ring held together by metal bars. In addition, the Milwaukee Brace incorporates a system of pads which are strapped into place according to the shape of the patient's spinal curve. These components work together to put pressure on the curve and force the torso into a straightened position while centering the head over the pelvis.
Because scoliosis braces are effective only in cases where the skeleton is not yet fully developed, it is necessary to consider the psychological and emotional ramifications that bracing can have upon young patients. Due to its high visibility and the fact that it must be worn for 23 hours per day, the Milwaukee Brace may negatively impact an adolescent's quality of life. A second type of brace, known as a Tharaco-Lumbo-Sacral-Orthosis (TLSO), is more compact and thus, if appropriate to a patient's particular curvature, may be a preferable option to the Milwaukee Brace.
TLSO actually indicates a family of scoliosis braces usually made of custom-fitted plastic, most often used to treat curvature of the mid- to lower-spine. Fairly easily concealed beneath clothing, a TLSO may be less obtrusive than the Milwaukee Brace. The most commonly prescribed TLSOs are the Boston Brace and the Charleston Bending Brace.
The Boston Brace comprises a plastic corset extending from beneath the breast area to the upper pelvis in the front and from the lower shoulder area to the buttocks in the rear. While the corset compresses the abdomen, forcing the lower spine into a flexed position, a system of pads similar to those used in the Milwaukee Brace exerts pressure on the spinal curve. When the brace is worn for the recommended 20 to 23 hours daily, these processes work to impede the worsening of spinal curvature.
Like the Boston Brace, the Charleston Bending Brace consists primarily of a custom-made plastic corset that hugs the torso. The Charleston brace, however, is designed to be worn for approximately eight hours per day as a patient sleeps. Typically, the brace is shaped so that it bends away from the scoliotic curve, counterbalancing it, and thus restricting further curvature.
Scoliosis brace designers have focused on creating flexible products, allowing greater comfort and freedom of movement for the wearer. One example of these flexible braces is SpineCor®, a vest-style apparatus that targets spinal curvature with its adjustable straps. Because such products have only existed for a limited time, their effectiveness has not been as thoroughly tested as that of older models.
A number of medical studies confirm the overall benefits of bracing; however, it is important to note that although treatment by brace can limit future curvature, it will not reverse pre-existing curves. Further, some scoliosis simply does not respond to bracing. Though this phenomenon is not yet totally understood, failure to wear one's brace exactly as prescribed can certainly contribute to its lack of success. Lastly, bracing is usually not appropriate where scoliotic curvature exceeds 40 percent; in these cases, patients might consider correction by surgery.
