Medical Health Encyclopedia

Many experts have questioned whether a brace is any better than nature in halting curvature progress in any patients. Early studies found that braces were successful in halting progression in only half of cases (the same rate as no treatment at all). In recent years, however, braces have improved. Many now fit under the arms and can be worn under the clothes, so that patients are much more likely to use them for longer periods during the day, which greatly affects their success rates.

Team Approach

Wearing the brace for the prescribed time is difficult but is essential for any success. A team approach, with several health professionals involved, is beneficial and often necessary to support the patient through the bracing process. An orthopedic surgeon interprets the x-rays, assesses the potential progression of the scoliosis, and plans the treatment with the patient and family. If a brace is used, an orthotist measures and fits the patient with the device. A physical therapist tailors an exercise program best suited for the patient. A nurse may also get involved to coordinate the treatment plans and provide physical and emotional support.

Types of Braces

Milwaukee Brace. A full torso brace called the Milwaukee brace was the standard treatment until a decade ago. It is still used particularly for high curves.

Text Continues Below

---

The device contains a wide flat bar in front and two smaller ones in back. These bars attach to a ring around the neck that has rests for the chin and back of the head. One study determined that lying on the chest when the brace is worn is the best position for correcting the curve. Some researchers then suggested that increasing the tension on the chest straps might add benefit. The brace is also periodically adjusted for growth.

The brace needs to be worn 23 hours a day, with relief during bathing and exercise only. Compliance is a major problem. In one study, only 15% of patients wore the Milwaukee brace as directed. It is a particularly difficult brace to endure wearing; one woman who had worn it for seven years during adolescence remembered herself as being invisible at school, ignored and shunned by other children.