Scoliosis is a musculoskeletal disease that causes lateral curvature of the spine, resulting in a spine that appears S- or C-shaped rather than straight. This condition typically affects children and adolescents, and while it can be self-correcting in many cases, some scoliosis conditions require treatment. Surgical treatment is possible but reserved only for severe cases; for moderate correction, bracing is a common and effective route.
Boston Brace
The Thoraco-Lumbo-Sacral-Orthosis brace, also known as the TLSO brace or Boston brace, is the most common type of brace used to treat scoliosis in children, according to the spinal health website Spine-Health. The Mayo Clinic describes it as a low-profile brace that is contoured to the body and fits under the arms, supporting the lower back, hips and rib cage. Because they stop midway up the back, this type of brace is not appropriate for treating curvature of the upper spine. Boston braces are typically made of molded plastic and can be worn under the clothing without being noticed. Users often wear the brace 23 hours per day, removing it for bathing and exercise.
Milwaukee Brace
The Cervico-Thoraco-Lumbo-Sacral-Orthosis, or Milwaukee brace, builds on the basic design of the Boston brace, according to Spine-Health. The Mayo Clinic describes this model as a full-torso brace with two upward-extending bars in the back and one in the front. These bars connect to a headgear apparatus that includes a neck ring, a chin rest and a support for the back of the head. The Milwaukee brace is used for thoracic spine curvatures and in situations where the Boston brace is determined to provide insufficient spinal correction and support. It is also typically worn for 23 hours per day.
Charleston Brace
The Charleston brace, unlike most other scoliosis braces, has a bit of give to it, making it more comfortable to wear while sleeping. According to Spine-Health, candidates with curvature that is between 20 and 40 degrees and which occurs below the shoulders may be able to effectively treat their scoliosis by only wearing a Charleston brace at night, with no need to wear one during the day. The Scoliosis Research Society reports that unlike traditional scoliosis braces, the Charleston brace is molded specifically for the patient. The patient must be placed in a specific prone pose in a laboratory setting, complete with corrective pressures on the spine, and fitted with a plaster or fiberglass cast. After the cast is set, it is removed and shipped to a facility where it is used to manufacture a custom Charleston brace.
Wilmington Brace
The Wilmington brace, according to the Scoliosis Research Society, may be considered a hybrid between the Boston brace and the Charleston brace. Like the Boston brace, it is designed to be worn throughout the day and night, it stops below the underarms and can generally be worn underneath the clothes without detection. Like the Charleston brace, though, it is custom-tailored to the wearer using a similar casting procedure. It is most appropriate for candidates with spine curvature between 25 and 39 degrees. It was developed as a response to the Milwaukee brace, which is effective when worn as prescribed, but can yield patient compliance issues because of its bulkiness and appearance. Studies cited by the society indicate that the Wilmington brace produces similar results to those of the Milwaukee brace.
