Effectiveness of braces in mild idiopathic scoliosis. x

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Miller JA. Nachemson AL. Schultz AB. x Spine. [JC:uxk] 9(6):632-5, 1984 Sep. x Despite the wide use of bracing for the treatment of idiopathic scoliosis, x controlled studies apparently have not been performed to examine whether x bracing, in fact, alters the natural history of spine lateral curves. We x studied 255 female patients, ages 8-17 years, with idiopathic scoliosis x who had curves with initial Cobb measures from 15-30 degrees. They were x divided into two groups: one group consisted of 144 patients who had x received a Milwaukee or Boston brace; and the other, a control group, x consisted of 111 patients who remained untreated through a mean period of x 1.9 years. The groups had similar mean ages, ages of menarche and curve x severities. The results showed a slight but nonsignificant trend, x suggesting that bracing reduced the overall probability of progression in x the braced curves. However, noting that nearly 75% of the control group x curves were nonprogressive, it is possible that a similar proportion of x the braced curves need not have been braced. Moreover, bracing failed to x prevent eight curves in seven patients (5%) from progressing. These curves x progressed at a mean rate of 8 degrees per year. Our retrospective results x suggest that bracing probably is not necessary in a large proportion of x patients who meet current, clinical criteria for bracing. Given the x limitations of retrospective studies like this one, a controlled x prospective trial of bracing effectiveness in idiopathic scoliosis seems x warranted. x