Jump to:  A   |   B   |   C   |   D   |   E   |   F   |   G   |   H   |   I   |   J   |   K   |   L   |   M   |   N   |   O   |   P   |   Q   |   R   |   S   |   T   |   U   |   V   |   W   |   X   |   Y

Braces Seem to Benefit Many Kids With High-Risk Scoliosis

THURSDAY, Sept. 19 (HealthDay News) -- For most children who otherwise might need surgery for scoliosis -- curvature of the spine -- having them wear a brace helps prevent their condition from worsening to the point where an operation is needed, a new study says.

In fact, the study was stopped early because of the positive results from bracing, when researchers found that 72 percent of the children using the brace improved and surgery wasn't needed, compared with 48 percent of the children not using one.

"Bracing significantly decreased the progression of patients who are at high risk for progression to the threshold where surgery would be indicated," said lead researcher Dr. Stuart Weinstein, a professor of orthopedic surgery at the University of Iowa.

"The study also showed that the more the children wore the brace -- the longer their brace hours -- the better the chances of success in avoiding surgery," he said. "We found children who wore the brace more than 13 hours a day have a significantly better outcome in preventing surgery than wearing it for less hours."

Many types of braces exist for kids, according to the Scoliosis Research Society. Successful treatment requires regular physical exams by an orthopedic surgeon, a well-fitted brace that's replaced when outgrown, as well as patient cooperation and family support, according to the society's website.

For the study, Weinstein's team randomly assigned 116 children to wear a brace or not. In addition, another 126 children were given the choice of wearing a brace or not. Patients with braces were told to wear them at least 18 hours a day.

High-risk patients are those with a spinal curve between 20 degrees and 40 degrees, and whose spines are still growing, Weinstein said. For these children between 10 and 15 years old, bracing should begin as early as possible, he added. The brace is designed to prevent the progression of the curve to around 50 degrees, which is when surgery is indicated.

It's not known why some children's scoliosis didn't progress without a brace, nor why some children's scoliosis progressed while wearing a brace, Weinstein said.

Bracing has been around since 1948, but doctors still disagree whether it is helpful, and up to now there hadn't been a study done to support or refute its value, he said.

The report was published online Sept. 19 in the New England Journal of Medicine, to coincide with the presentation of the findings at the annual meeting of the Scoliosis Research Society in Lyon, France.

"This confirms our suspicion all along that bracing does change the outcome of scoliosis in adolescents," said Dr. Harry Shufflebarger, director of the division of spinal surgery at Miami Children's Hospital. He was not involved with the new study.

The problem is that there is no way of telling who needs a brace and who doesn't, he said. "You can find a high-risk population and offer it to all of them with the explanation that some of you guys don't need a brace, some of you do and we can't differentiate."

Another doctor, Dr. Eugene Carragee, a professor of orthopedic surgery at Stanford University School of Medicine, agreed that it's not clear who actually benefits from bracing.

There are many types of spinal curves, including upper and lower spine curves, double curves and curves that tilt right and those that tilt left, said Carragee, who wrote an accompanying journal editorial.

"The study doesn't have enough people to be able to break it out to say which of these curves are going to do better with a brace," he said. "It is very likely there is a subgroup for whom the brace is highly effective, but there is also a subgroup where it's not effective," Carragee said.

"The research still needs to be done to separate the curves that are braceable from the curves that are not," he said.

More information

To learn more about scoliosis, visit the U.S. National Library of Medicine.

SOURCES: Stuart Weinstein, M.D., professor, orthopedic surgery, University of Iowa, Iowa City; Eugene Carragee, M.D., professor, orthopedic surgery, Stanford University School of Medicine, Stanford, Calif.; Harry Shufflebarger, M.D., director, division of spinal surgery, Miami Children's Hospital; Sept. 19, 2013, presentation, Scoliosis Research Society annual meeting, Lyon, France; Sept. 19, 2013, New England Journal of Medicine, online

Reviewed Date: --

Find a pediatrician
Sports Medicine and Adolescent Medicine
Joel Brenner, MD
Aisha Joyce, MD
David Smith, MD
Childrens Orthopedics and Sports Medicine
J. Marc Cardelia, MD
Allison Crepeau, MD
Cara Novick, MD
H. Sheldon St. Clair, MD
Carl St. Remy, MD
Allison Tenfelde, MD
Children's Cardiac Surgery
Benjamin B Peeler, MD
Felix Tsai, MD
Childrens Orthopedics and Sports Medicine
J. Marc Cardelia, MD
Allison Crepeau, MD
Cara Novick, MD
H. Sheldon St. Clair, MD
Carl St. Remy, MD
Allison Tenfelde, MD
Neurosurgery
John Birknes, MD
Joseph Dilustro, MD
Children's Plastic Surgery
George Hoerr, MD
Jesus Inciong, MD
Pediatric Surgery
Frazier Frantz, MD
Michael Goretsky, MD
Robert Kelly, MD
M. Ann Kuhn, MD
Michele Lombardo, MD
Robert Obermeyer, MD
Health Tips
A Parent’s Guide to Choosing Child Care
Boost Your Teen Daughter’s Body Image
Cool Tools to Keep Your Kids From Smoking
Growing Up Short or Heavy Can Be Difficult
Help Your Babysitter Prepare for Anything
Helping Children Conquer Fear
How Old Is 'Old Enough' for Contacts?
How to Prevent Childhood Obesity
Kids' Health Concerns Ease with Age
Scoliosis
Teen Suicide: Learning to Recognize the Warning Signs
Teens and Talk: What's a Parent to Do?
Treating Teen Acne
What Kids Drink Is Important, Too
When Your Child Says, 'I'm Sick'
Quizzes
Scoliosis Quiz
Teen Health Quiz
Diseases & Conditions
Adolescent (13 to 18 Years)
Adolescent Mental Health Overview
Adolescents and Diabetes Mellitus
AIDS/HIV in Children
Amenorrhea in Teens
Anatomy of a Child's Brain
Anatomy of the Endocrine System in Children
Anxiety Disorders in Children
Asthma and Children
Asthma in Children Index
Bicycle, In-Line Skating, Skateboarding Safety--Injury Statistics and Incidence Rates
Bipolar Disorder in Children
Bone Marrow Transplantation in Children
Brain Tumors in Children
Breast Conditions
Chemotherapy for Children: Side Effects
Child Care
Diphtheria in Children
During an Asthma Attack
Dysmenorrhea in Adolescents
Ewing Sarcoma
Female Growth and Development
Firearms
Growth-Related Disorders
Gynecological and Menstrual Conditions
Hepatitis B (HBV) in Children
High Blood Pressure in Children and Adolescents
Home Page - Adolescent Medicine
Infectious Mononucleosis in Adolescents
Inflammatory and Infectious Musculoskeletal Disorders
Inflammatory and Infectious Neurological Disorders
Inguinal Hernia in Children
Insect Bites and Children
Kidney Transplantation in Children
Major Depression in Adolescents
Meningitis in Children
Menstrual Disorders
Mood Disorders in Children and Adolescents
Muscular Dystrophy
Myasthenia Gravis in Children
Obesity in Adolescents
Oral Health
Osteosarcoma in Children
Overview of Adolescent Health Problems
Pap Test for Adolescents
Pediatric Blood Disorders
Poliomyelitis (Polio) in Children
Post-Traumatic Stress Disorder in Children
Preparing the School-Aged Child for Surgery
Schizophrenia in Children
School-Aged Child Nutrition
Scoliosis in Children
Slipped Capital Femoral Epiphysis
Sports Safety for Children
Superficial Injuries Overview
Television and Children
Thalassemia
The Growing Child: 2-Year-Olds
The Growing Child: Adolescent (13 to 18 Years)
The Heart
The Kidneys
Vision Overview
Whooping Cough (Pertussis)
Wisdom Teeth Extraction in Children

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.