Types of Braces for Scoliosis
There are a variety of braces that are available for treating scoliosis; your doctor will prescribe the one that's right for you based on the type, location and degree of your curve.
There are several different types of braces commonly used to treat the spinal curves associated with scoliosis. They include:
There are a variety of TLSO braces, but the one most commonly used to treat scoliosis is the "Boston Brace." TLSO braces are often called "low-profile" or "underarm" braces. They are not as large or bulky as the Milwaukee Brace (see below), and their plastic components are custom-molded to fit the patient's body.
The Boston Brace extends from below the breast to the beginning of the pelvic area in the front and from below the shoulder blades to the tail bone in the back. This type of brace works by applying three-point pressure to the curve to prevent its progression. It forces the lumbar area to flex, which pushes in the abdomen and flattens the posterior lumbar curve. Strategically placed pads place pressure on the curve, and "relief voids" are located opposite the areas of pressure.
Developed in the early 1970s by Dr. John Hall and Mr. William Miller of The Boston Children's Hospital, the Boston Brace is typically prescribed for curves in the lumbar (low-back) or thoraco-lumbar (mid- to low-back) sections of the spine.
Charleston Bending Brace
Another bracing option is the Charleston Bending Brace. Developed in 1979 by Dr. Frederick Reed and Ralph Hooper, the Charleston Bending Brace is worn only at night, which is why it's also known as a "part-time" brace
The Charleston Bending Brace is molded to conform to the patient's body while he or she is bent towards the convexity—or outward bulge—of the curve, the concept behind this design being that it "over-corrects" the curve during the eight hours the brace is worn.
The Charleston brace is typically recommended for spinal curves of 20-35 degrees, with the apex of the curve below the level of the shoulder blade.
Other braces your doctor may recommend include:
- The Providence Brace, a computer-fitted brace worn only at night.
- A bracing method called SpineCor, which uses adjustable bands and a cotton vest that allows flexibility.
- The Wilmington Brace (TLSO), a total-contact orthosis typically fabricated from a lightweight plastic material called Orthoplast. The brace is designed as a "body jacket," with a front closure and adjustable Velcro straps.
The Milwaukee Brace is commonly used for high thoracic (mid-back) curves. It extends from the neck to the pelvis and consists of a specially contoured plastic pelvic girdle and a neck ring connected by metal bars in the front and the back of the brace. The metal bars help extend the length of the torso and the neck ring keeps the head centered over the pelvis. Pressure pads, strategically placed according to the patient's curve pattern, are attached to the metal bars with straps.
The Milwaukee Brace was the first modern brace designed for the treatment of scoliosis. Developed by Drs. Walter Blount and Albert Schmidt of the Medical College of Wisconsin and Milwaukee's Children's Hospital in 1945, its design has been tweaked through the years until reaching its current design around 1975. Today, the brace is used less frequently now that more form-fitting plastic braces have been developed; however, it's still prescribed for some types of curves that are located very high in the spine.
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