Scoliosis is a condition characterized by a sideways curvature of the spine, where the spine may resemble a “C” or “S” shape when viewed from behind. This spinal deviation can affect individuals of all ages, though it most often begins in children between 10 and 15 years old. When people refer to “scoliosis machines,” they are generally talking about non-surgical devices, primarily braces, used to manage this spinal condition. These braces serve to prevent the spinal curve from progressing further, especially during periods of rapid growth.
Understanding Scoliosis Braces
Scoliosis braces, often referred to as “scoliosis machines,” come in various types, each designed to address specific curve patterns and locations. One widely used type is the thoracolumbosacral orthosis (TLSO), which covers the torso from just below the arms to the hips. The Boston brace is a common example of a TLSO, a rigid plastic shell that is custom-molded to fit the patient’s body and spine curvature, typically closing in the back. This brace is often prescribed for curves in the lower back or mid-lower back regions.
Another type is the Milwaukee brace, which is a cervico-thoracic-lumbar-sacral orthosis (CTLSO). This older, bulkier brace extends from the pelvis to the neck, incorporating a neck ring and chin rest for additional support. While less common today due to newer, more comfortable designs, it is sometimes used for higher thoracic or cervical spine curves. Additionally, nighttime braces like the Charleston bending brace and Providence brace are designed to be worn only during sleep, applying corrective forces while the patient is lying down. The Providence brace, for example, elevates one shoulder slightly and applies direct lateral and rotational forces to the curve.
How Braces Correct Scoliosis
Scoliosis braces work by applying specific external forces to the spine, aiming to influence its growth and prevent the curve from worsening. The fundamental principle often involves a three-point pressure system. This system applies pressure on the outer edge of the spinal curve, pushing the spine back toward a more aligned position.
This constant, directed pressure helps to counteract the asymmetrical loading on the vertebrae that can lead to their wedge-shaped deformity in scoliosis. While wearing the brace, the spine is held in a straighter, unrotated position. Modern braces, such as the Rigo-Cheneau and Boston Brace 3D, are designed to address the three-dimensional nature of scoliosis, including the rotational component of the spine. The goal is to encourage symmetrical growth and prevent the curve from progressing to a point where surgery might be necessary.
Who Benefits from Brace Treatment
Brace treatment is typically recommended for growing children and adolescents with a spinal curvature that falls within a specific range. Generally, a brace is considered when the curve measures between 25 and 40 degrees. The patient’s skeletal maturity is a significant factor, as braces are most effective while the spine is still growing.
Evidence of curve progression, such as an increase of 5 to 10 degrees in six months, can also indicate the need for bracing, even for curves less than 25 degrees if there is pronounced skeletal immaturity. The main objective of bracing is to prevent the curve from worsening and avoid spinal fusion surgery, often recommended for curves exceeding 50 degrees. While braces are not typically used for adult scoliosis, there can be exceptions based on individual circumstances.
Daily Life with a Scoliosis Brace
Adjusting to wearing a scoliosis brace involves practical considerations and emotional support. Full-time braces, such as the Boston brace, are typically worn for 18 to 23 hours per day, with removal usually allowed for bathing and certain physical activities like swimming. It is important to wear a snug-fitting, thin, moisture-wicking shirt under the brace to prevent skin irritation, redness, or blisters. Daily cleaning of the brace with mild soap and water, or rubbing alcohol, is also recommended to maintain hygiene and prevent skin issues.
Managing physical activities often means continuing most non-contact sports like biking, golf, and walking while wearing the brace. Clothing choices may need adjustment, with loose-fitting shirts and pants often preferred to conceal the brace and allow for comfort. The initial two weeks of brace wear can be the most challenging, as individuals adapt to the feeling of the device. Emotional adjustment is supported by open communication, allowing individuals to express frustrations, and receiving encouragement from family and friends.
Treatment Outcomes and What to Expect
Successful scoliosis brace treatment primarily prevents the spinal curve from progressing to a degree that would necessitate surgery. Studies have shown that bracing can be highly effective in achieving this goal, with success rates reported to be around 70-85% in preventing curve progression. The effectiveness of bracing is directly linked to consistent wear, with studies indicating that wearing the brace for the recommended number of hours significantly increases the likelihood of avoiding surgery.
Brace wear typically continues until skeletal maturity, which marks the end of significant bone growth, often lasting two to four years. After this period, the brace wearing time is gradually reduced over several months, with X-rays performed to confirm the stability of the curve without the brace. Continued monitoring and follow-up care are important even after bracing ceases, to ensure the curve remains stable. While bracing aims to halt progression, some patients may also experience a reduction in their curve.