Brace (orthotic) treatment for
scoliosis is used to prevent spinal curve progression
and to maintain the appearance of the back.
The goal of brace treatment is to prevent the curve from getting
worse. Bracing does not correct a curve. There may be some initial
straightening of the spine and the appearance of correction when a brace is
applied. But in most cases, after the child stops wearing the brace, this
correction is lost and the curve returns to its original shape.
What To Expect After Treatment
In most cases, any correction of the curve that occurred during
bracing is lost, and the curve returns to its original shape after bracing is
Why It Is Done
Brace treatment is used for a child who is still growing to prevent
progression of moderate spinal curves. Brace treatment is usually
continued until the child's skeleton stops growing.
Two common types of braces include the:
- CTLSO, which stands for cervical-thoracic-lumbar-sacral
orthosis. This brace consists of a customized
pelvic girdle and a metal structure that extends to the neck. This brace is not
hidden by clothing. The CTLSO is used to treat curves high in the
upper back, such as kyphosis (hunchback). The brace treatment of kyphosis in
the upper back can often result in correction.
- TLSO, which stands for thoracic-lumbar-sacral
orthosis. This brace consists of a trunk and pelvic girdle
that is customized to fit the child. It is used to treat curves in the mid back
and lower back. This brace does not have a metal structure and can be hidden by
clothing better than the CTLSO can be.
Braces are not effective for curves greater than 45 degrees.
How Well It Works
Most research on using braces for scoliosis has focused on idiopathic scoliosis. In general, the research shows that braces can be effective for preventing curves from getting worse. The more the child wears the brace, the more effective the brace can be.
Braces are generally effective in providing immediate control of
curves1. When a brace is first applied, a significant correction is often seen.
But after the child stops wearing the brace, the curve usually
Although bracing does not always prevent a spinal curve from
getting worse, the best results occur when:
- Bracing is started early, while the child is
- The spinal curve is moderate, not severe.
brace is well fitted.
- The child wears the brace for the prescribed
amount of time.
- There is family support for the child.
Complications of bracing therapy include:
- A child not
wearing a brace for the prescribed amount of time,
which allows the curve to get worse.
What To Think About
Children who wear braces are examined by a doctor regularly (such
as every 3 months or 6 months or more frequently if problems arise) to monitor
the effects of the brace.
A child who has a severe forward curve in his or her upper back in
addition to scoliosis may not be well suited for bracing.
Children can ride a bicycle, play tennis, run, and jump while
wearing a brace. But they should not participate in activities such as
horseback riding, skiing, skating, and gymnastics while wearing a brace.
Because wearing a brace makes many physical activities difficult, children or
teens are typically advised to remove their braces when they participate in
activities such as physical education classes.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
Weinstein SL, et al. (2013). Effects of bracing in adolescents with idiopathic scoliosis. New England Journal of Medicine, 369(16): 1512–1521.
Other Works Consulted
Negrini S, et al. (2010). Braces for idiopathic scoliosis in adolescents (Review). Cochrane Database of Systematic Reviews (1).
Rowe DE (2003). The Scoliosis Research Society Brace Manual. Available online: http://www.srs.org/professionals/education_materials/SRS_bracing_manual/section1.pdf.
Spiegel DA, Dormans JP (2011). Idiopathic scoliosis. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 2365–2368. Philadelphia: Saunders.
Primary Medical Reviewer
||John Pope, MD - Pediatrics
Specialist Medical Reviewer
||Robert B. Keller, MD - Orthopedics
Current as of
||February 5, 2014