Bracing, Surgery and Observation
Bracing is regularly recommended for scoliosis curvatures between 25-45 degrees. The supposed logic of using a brace is to prevent the scoliosis curvature from progressing. The traditional hard brace usually used at hospital, such as the Boston Brace or Milwaukee brace is often worn for as long as 23 hours per day and it's usually very bulky in design and can easily can be seen if you wear a T-shirt over the brace. Traditional bracing can often cause severe pain (because it's NOT precise fitting), a decrease in lung function, increase in rib deformity, may cause severe skin irritation, and weakening of muscles.
A 2007 article appearing in the journal Spine gave bracing an overall grade of a “D” for its ability to halt curve progression. Both patients and researchers tend to agree that we need a better system for treating scoliosis.
Soft braces like Spinecor are even worse at preventing the scoliosis from progressing for most scoliosis cases above 25 degrees with vertebrae rotation.
In 2019, we have better bracing technology and material at Bones and Beyond. We only recommend the brace if we feel that it is necessary. The brace when designed precisely will not cause pain, will NOT decrease lung function, will NOT increase rib deformity and will not cause severe skin irritation. Because it's a TRUE CUSTOM FITTING, OUR BRACE SHOULD NOT BE VISIBLE WHEN WORN UNDER A T-SHIRT. IT NOT BULKY PERIOD!
We normally recommend the brace in conjunction with our in office scoliosis treatment program to prevent weakening of muscles and establish a new subconscious spinal pattern in the brain and spine.
Surgery is traditionally recommended for scoliosis curvatures above 40-45 degrees. However, many long-term studies indicate poor treatment outcomes for surgically-treated patients, and some studies even recommend a second surgery for complete removal of the hardware implanted by the surgery after bony fusion has taken place. Research indicates that surgical intervention, while possibly necessary at times for very large spinal curvatures, is primarily a cosmetic procedure which ultimately leaves the complex condition of scoliosis untreated. The surgical procedure simply transforms the spinal deformity into a permanent spinal dysfunction that often results in chronic pain, disfigurement, and even long-term disability. While scoliosis surgery has improved over the past several decades, choosing surgery is never easy, and many patients find that the risks and poor treatment outcomes make this a last resort.
Before considering surgery, it would be wise to do research on the pros and cons of specific types of surgery. At Bones and Beyond we are not against surgery or any types of scoliosis treatment for that matter. We wants all scoliosis patient to be inform about their scoliosis condition as accurately as possible so that you, the patient, will make the decision on which type of treatment is best for your scoliosis condition.
The "watch and wait" method has been traditionally recommended for scoliosis curvatures between 0-25 degrees. This strategy involves monitoring the progression of the scoliosis from the point of detection up until the scoliosis curvature reaches 25 degrees or the child reaches skeletal maturity. Most doctors think that after skeletal maturity has been reached the curvature will not get worse, but this is far from the truth. In fact more than two-thirds (68%) of scoliosis curvatures will continue to worsen following skeletal maturity according to Weinstein et al. in "Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients," Journal of Bone Joint Surgery Am. 63:702-712, 1981.
It is much easier to reduce a smaller scoliosis curvature versus a larger scoliosis curvature with our scoliosis reduction method following the CLEAR protocol.