The question of how long a scoliosis brace must be worn is common for individuals diagnosed with adolescent idiopathic scoliosis (AIS). Bracing is a non-surgical treatment aimed at preventing the sideways curvature of the spine from worsening during the body’s rapid growth period. A brace is not designed to permanently correct the curve, but rather to hold the current angle stable until the spine has finished growing. The total time in a brace is highly individualized, depending on the patient’s rate of physical maturation.
The Typical Bracing Timeline
The duration of full-time bracing ranges from one to five years, with the average commitment falling between two and four years. This wide range exists because the treatment’s end point is the cessation of skeletal growth, not a specific date. For a rigid, full-time brace to be effective, patients are advised to wear it for 16 to 20 hours per day. Studies show a strong correlation between the hours worn and success in halting curve progression.
Wearing the brace for the prescribed hours applies continuous pressure to guide the spine’s growth and is most effective when the patient is still skeletally immature. The goal is to maintain the curve within a non-surgical range until the spine is no longer vulnerable to progression caused by growth spurts. During this period, the spine is flexible enough for the brace to exert a corrective force, acting as a mold to ensure the vertebrae grow in a straighter alignment.
The length of time a person has left to grow is the greatest determinant of how long they will wear the brace. Once skeletal maturity is reached, the risk of curve progression significantly decreases, and the brace is no longer needed. For girls, this period often concludes around ages 14 to 16, and for boys, around ages 16 to 18.
Variables That Influence Treatment Duration
Several biological and physical factors determine where a patient falls within the typical one-to-five-year treatment window. The age at which the scoliosis is diagnosed is a major variable; a younger patient has a greater amount of growth remaining, which translates to a longer bracing period. The severity of the curve when bracing begins also plays a role, as larger curves require more intensive management and monitoring to prevent progression.
The rate of growth progression is another important factor, particularly during the pubertal growth spurt. Patients experiencing a rapid increase in height are at a higher risk for curve worsening, demanding intense focus and adherence to the full-time wear schedule. This period is when the spine is most susceptible to curve progression.
Patient compliance—the consistent, daily adherence to the prescribed hours—is directly linked to the total duration of treatment. A lack of compliance can undermine the brace’s effectiveness, potentially leading to curve progression and prolonging the overall need for bracing. Conversely, consistently wearing the brace as directed increases the likelihood of achieving the goal sooner.
Milestones That Signal the End of Bracing
The decision to discontinue bracing is based on verifiable medical and physical criteria that confirm skeletal maturity has been reached. The primary medical marker used by physicians is the Risser Sign, or Risser Scale, which is assessed via an X-ray of the pelvis. This scale ranges from 0 to 5, tracking the ossification, or hardening, of the iliac crest—a part of the hip bone.
A Risser grade of 0 indicates the most growth is still ahead, while a grade of 5 signifies complete skeletal maturity and the end of growth. Doctors typically wait until a patient reaches a Risser grade of 4 or 5 before considering weaning them out of the brace. For female patients, the occurrence of menarche is another significant physical milestone.
The cessation of menses usually indicates that the period of most rapid growth has passed, with only limited growth remaining. A patient is often considered to have reached skeletal maturity two years after menarche. Doctors also look for height stability—no significant change in height measured over a six-month period—to confirm the spine has finished growing and bracing can be concluded.