Scoliosis is an abnormal curvature of the spine that can cause difficulty walking, sitting and bending. When the spinal curvature is at 25 to 45 degrees and skeletal growth is still a possibility, braces may be used to try to correct the abnormal curve. There are several types of braces used to treat this condition: TSLO, full-torso, nighttime and flexible braces.
TSLO Braces
The Boston brace, also known as thoracolumbar-sacral orthoses (TSLO), is an uncomfortable brace that can reduce quality of life for those suffering from scoliosis. This brace is molded to the patient's body and fitted close to the skin so that it cannot be detected under clothing. It is most often used to treat curves of the lower and middle back. If the brace is not worn as directed, spinal curvature can worsen over time. These braces can cause patients to become uncomfortably hot. They also reduce lung capacity and cause temporary decreases in the function of the kidneys. The amount of time the brace is worn each day will be determined by the treating doctor's prescription. However, a study led by Dr. Jeff Wiley of Connecticut Children's Medical Center found that the best treatment results occurred in patients who wore their braces for more than 18 hours each day.
Full-Torso Braces
The Milwaukee brace is also known as a full-torso brace. This was the typical treatment for scoliosis until better alternatives were created. This brace has a wide, flat bar in the front and two smaller bars in the back. Once the brace is placed on the torso, the bars attach to a ring that is around the neck. The ring has a chin rest and a rest for the back of the head. The Milwaukee brace has to be worn for 23 hours per day and may only be removed for bathing and exercise. This presents a problem for doctors who need their patients to comply with treatment directions. The University of Maryland cites a low 15 percent compliance rate for people who are instructed to wear this type of scoliosis brace. Now that other braces are available, this brace is used mostly to treat high spinal curvature.
Nighttime Braces
The Charleston Bending brace is worn at night. Patients may be more likely to comply with this type of treatment since the brace can be removed to attend work or school. The brace consists of molded plastic with three adjustable straps that hold it in place. While some doctors do not believe that this type of brace is effective, a 2002 study cited by the University of Maryland indicated that it is just as effective as the Boston brace.
The Providence Nighttime Scoliosis System is a computer-fitted brace made of plastic. It is also worn only at night and is particularly effective in treating double curves. James Benelli of Spinal Technology, Inc. cites a 98 percent effectiveness rate for this system.
Flexible Braces
SpineCor is a flexible scoliosis brace that consists of two sections, which allows for increased movement and flexibility. The first section contains a pelvic base, crotch bands and thigh bands. This section supports the patient's trunk. The second section contains a bolero and a set of corrective elastic bands. This section is responsible for correcting the curvature caused by scoliosis. The SpineCor brace allows patients to remove their braces for four hours each day and provides freedom of movement. These benefits can result in increased compliance with bracing treatment.
The TriaC scoliosis brace is a more flexible alternative to the Boston brace that offers a better range of motion and improved cosmetic appearance. It is a tension-based system that allows the lumbar and thoracic sections to move independent of each other. The brace is fitted to the patient and consists of prefabricated straps and bars. Despite improved appearance and comfort, a study conducted by orthopedic surgeons from Martin-Luther-University of Halle-Wittenberg found that the brace was ineffective in treating thoracic curves and double curves.
