Boston Othotics and Prosthetics

Bracing

How effective is bracing for scoliosis?

There are many factors that determine how effective bracing can be, including compliance to a full-time wear schedule, the design of the brace, the expertise of the orthotist, along with other factors we do not yet understand.

While the patient is wearing the brace, we want to see the curve reduce. This is called in-brace correction.

The goal of bracing is to stop curve progression; depending on age, curve type, severity, and flexibility, we may be able to obtain some correction after the brace is removed.

A 2013 report called the BrAIST Study provided evidence of the effectiveness of bracing in treating adolescent idiopathic scoliosis. In fact, bracing was shown to be so effective that the study had to be stopped early because it was deemed unethical to deny the treatment to other patients who may benefit from bracing.

How long will my child have to wear a scoliosis brace?

Ultimately, this is up to the orthopedic doctor who is treating the patient. There are a few factors that are taken into consideration when deciding whether to discontinue brace wear. Primarily, the doctor will assess the amount of growth remaining, which is a significant risk factor in the progression of scoliosis. They may take a wrist and hand X-ray, (the Sanders Maturity Scale method) which is a way to look at the growth plates and make a determination about how much growth there is remaining. They may also look at your hips in the X-ray, (the Risser sign) as a large growth plate here can indicate your growth status. For females, they may ask if you’ve started a consistent menstrual cycle, as this can be linked to remaining growth. 

How often will my child need a new scoliosis brace?

This depends on growth! Our primary objective is to keep the child in a brace that fits and functions well. The patient will follow up with their orthotist at regular intervals (usually in conjunction with orthopedic MD follow-ups), at which point the fit of the brace will be assessed. The typical lifespan of a scoliosis brace is 12 to 18 months, but the brace may last for a longer or shorter time period based on growth.

Will a scoliosis brace show through clothes?

The brace will feel much more visible to you than it is to other people. Often it is very hard for others to tell that you have a brace on when you are wearing clothes over it. Some darker patterns may show slightly under lightweight, light color cotton tees. Different styles of braces also show more than others. The Boston 3D is a posterior opening brace, which allows the straps and buckles to be placed in the back, which makes hiding this aspect of the brace slightly easier than with an anterior opening design. A form-fitted tee is worn under the brace, and then clothes can be worn over top. 

Will I be able to put a scoliosis brace on myself?

Yes! It may take some practice, and it helps to have a mirror behind you to see how tight you are pulling the straps, but most of our patients are able to put their brace on themselves. Need more help? See our video on how to put on your scoliosis brace.

What is the difference between night-time and full-time scoliosis braces?

Night-time bracing systems are meant to worn for sleeping and just before bed only. Full-time braces are typically worn more hours during the day and at night, and are designed to be worn in an upright position.

In-brace X-rays taken with a night-time brace should be taken with the patient supine because that is how the patient wears it sleeping. The full-time brace in-brace X-rays are taken standing because the patients are typically upright during the day.

Some patients are not able to sleep with a night-time brace due to the corrective forces being more aggressive because they wear it for a shorter length of time. Some patients can’t tolerate full-time braces due to the restrictive nature of having it on during the day.

The decision must be made by the doctor and family to decide which design is best in the patient’s situation.

How much does a scoliosis brace cost?

Boston O&P will submit all appropriate codes to your insurance after your evaluation, and a billing specialist will be in touch to discuss any out-of-pocket expenses. The price of the brace is inclusive of in-office follow-up visits. The amount owed will depend on copays, deductibles, and other factors, and will be determined prior to an individual being fit with their brace, so there are no surprise costs.

Does the amount of time you wear a scoliosis brace make a difference?

Absolutely. Scientific studies have shown that the amount of time a patient wears their brace is closely associated with their outcomes. The specific recommended hours will be determined between you and your physician. Age, growth remaining, curve size are all factors that determine the proper hours of wear. 

The iButton thermal sensor is standard in all Boston Brace 3D braces to help the patient know their actual hours of wear time.

What activities can my child do in a scoliosis brace?

We want you to stay active and involved in doing all the sports and activities you enjoyed prior to bracing—keeping your body moving is important! That being said, we recommend taking your brace off for more involved activities such as running, dancing, gymnastics, and gym class. (Tip: try and make up some extra hours in the brace on days that are lower activity to reach your wear-time goals). If you are unsure about a certain activity, consult your orthotist for further direction.