Spinal bracing for Adolescent Idiopathic Scoliosis has NO effect on the natural course of Adolescent Idiopathic Scoliosis (I knew it!)
The creators of the Scoliscore genetic test plotted the results of brace treatment against the expected/predicted genetic course of the condition. Guess what? The results matched almost perfectly, which means spinal bracing doesn't alter the condition in any way, shape, or form. It basically proves that brace treatment is pretty much worthless and does not reduce or eliminate ANY of the environmental factors (forward head posture, loss of normal curve in the neck, hip rotation, etc) that cause AIS when combined with pre-disposing genetic factors. This is EXACTLY why CLEAR Institute( a non profit scoliosis educational organization) doesn't recommend invasive, expensive, and ineffective spinal bracing in its treatment programs.
It should be recognized that this study only used data from North American braces and did not include data from the Spine Cor brace, but I seriously doubt they would perform any differently since the same basic bracing concepts still hold true in those types of braces as well.
Over-correction bracing may produce a "guided growth" type effect via the Hueter-Volkmann principle, but is only achieved through manipulation of secondary adaptations to the condition and cannot be considered working towards a cure. Approximately 1% of genetically pre-disposed AIS patients can and will potentially benefit from this type of approach, but the cost/risk/benefit must be weighted against other guided growth type treatments like vertebral body stapling (VBS). However, VBS seems to be most effective when applied to a skeletally immature spine with a cobb angle of 35 degrees or less. A skeletally immature patient (who is part of the 1% genetically high risk) with a cobb angle greater than 35 degrees probably should be the only patients for which guided growth type bracing should be considered.
Bottom line: For 99% of the non-high risk AIS patients bracing does not change any of the environmental (or genetic) factors that create AIS and therefore has no bearing on the condition's natural course. The entire premise of spinal bracing is fundamentally flawed and any attempts to develop a build off those flawed fundamentals will be flawed by default.
At what point are we going to get our heads out of the sand (or out of other places) and realize that we are doing a major disservice to 99% of scoliosis treatment patients for whom spinal bracing is recommended. It all starts with a major PUSH for earlier & more effective screening, a mass movement towards genetic testing as many AIS kids as possible and genetic risk appropriate early stage scoliosis intervention ASAP.
The creators of the Scoliscore genetic test plotted the results of brace treatment against the expected/predicted genetic course of the condition. Guess what? The results matched almost perfectly, which means spinal bracing doesn't alter the condition in any way, shape, or form. It basically proves that brace treatment is pretty much worthless and does not reduce or eliminate ANY of the environmental factors (forward head posture, loss of normal curve in the neck, hip rotation, etc) that cause AIS when combined with pre-disposing genetic factors. This is EXACTLY why CLEAR Institute( a non profit scoliosis educational organization) doesn't recommend invasive, expensive, and ineffective spinal bracing in its treatment programs.
It should be recognized that this study only used data from North American braces and did not include data from the Spine Cor brace, but I seriously doubt they would perform any differently since the same basic bracing concepts still hold true in those types of braces as well.
Over-correction bracing may produce a "guided growth" type effect via the Hueter-Volkmann principle, but is only achieved through manipulation of secondary adaptations to the condition and cannot be considered working towards a cure. Approximately 1% of genetically pre-disposed AIS patients can and will potentially benefit from this type of approach, but the cost/risk/benefit must be weighted against other guided growth type treatments like vertebral body stapling (VBS). However, VBS seems to be most effective when applied to a skeletally immature spine with a cobb angle of 35 degrees or less. A skeletally immature patient (who is part of the 1% genetically high risk) with a cobb angle greater than 35 degrees probably should be the only patients for which guided growth type bracing should be considered.
Bottom line: For 99% of the non-high risk AIS patients bracing does not change any of the environmental (or genetic) factors that create AIS and therefore has no bearing on the condition's natural course. The entire premise of spinal bracing is fundamentally flawed and any attempts to develop a build off those flawed fundamentals will be flawed by default.
At what point are we going to get our heads out of the sand (or out of other places) and realize that we are doing a major disservice to 99% of scoliosis treatment patients for whom spinal bracing is recommended. It all starts with a major PUSH for earlier & more effective screening, a mass movement towards genetic testing as many AIS kids as possible and genetic risk appropriate early stage scoliosis intervention ASAP.
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