When it comes to non-operative treatment of adolescent idiopathic scoliosis (AIS), bracing has long been the standard solution. But while this practice has been around for decades, there is still a lack of conclusive evidence as to its effectiveness. Now come the findings of a study that strongly supports the case for bracing as a means of arresting the progression of spine curvature and thus eliminating the need for surgery.
The study was led by Dr Stuart Weinstein and Dr Lori Dolan from the University of Iowa. Their team enlisted 383 patients in the US and Canada for the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) between March 2007 and February 2011. The researchers selected subjects seen at high risk of continued deterioration in their spinal curves.
Patients placed in the observation group were not given any specific treatment, while the members of the bracing group were asked to wear a brace 18 hours every day. Lack of treatment success was considered a curve progression to 50 degrees or more, which is typically the point when surgery comes into play.
In January this year the researchers ended the trial ahead of schedule, having established that bracing greatly reduced the risk of deterioration and the need to resort to operative treatment. They found that the success rate increased along with the number of hours a brace was worn. Among the bracing sample, 72% of patients had positive outcomes, while the success rate stood at 90% to 93% when average daily wear exceeded 13 hours. The report also highlighted the fact that even patients wearing the brace infrequently achieved positive results: this was the case with 48% of such subjects in the observation group and 41% of those in the bracing group.