Bracing is considered the first line of scoliosis treatment in skeletally immature patients whose spinal curve is about 25 degrees. Bracing has been shown effective in preventing curve progression with the ultimate goal to halt curve progression until growth is complete. Although bracing does not permanently reduce the extent of the curve, there is a direct correlation in extent of brace wear and overall effectiveness.

The braces we most often use are the TLSO/Boston brace, Providence nighttime brace and occasionally the Milwaukee brace. They are custom created for each patient. After measurements are completed, it may take up to six weeks to receive the custom brace and start the breaking-in process. The braces will be introduced to full time wear over a few weeks’ time.

The goal for brace wear is 24 hours a day with removal for hygiene and extracurricular activities only. A thin shirt can be worn underneath the brace to prevent skin breakdown. The brace often can be hidden under clothes. In order to evaluate a brace, an X-ray is taken while your child is wearing the brace. It should reduce the curve about 50 percent for the most successful outcome.

Bracing is generally no considered effective in curves of more than 40 degrees. Surgery should be considered for curves of 40 to 50 degrees, as curves around 50 degrees have a risk of progression over a patient's lifetime even after skeletal maturation.

Before x-ray
8-year-old girl with 32-degree spinal curve
After X-ray
Same 8-year-old girl after treatment with Boston brace