Bracing in scoliosis

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Nonoperative brace treatment has been the hallmark of the management of idiopathic scoliosis for the past 30 years. Other than surgical fusion for severe curves, no other treatment has emerged as effective at changing the natural history of progression. Recent studies confirm the effectiveness of the underarm thoracolumbosacral orthosis in the immature skeleton, and a variety of new brace designs have increased patient acceptance in the moderate group for whom treatment is applicable. New data suggest that further brace design modifications will be necessary to improve their function. Bracing for neuromuscular curves remains controversial with regard to preventing progression, although it does appear to be helpful for positioning.

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