The TLSO Brace Puts a Halt to Progressive Spinal Curves of Scoliosis
Kids with adolescent idiopathic scoliosis have a type of curvature of the spine. It starts to show up at about age 10. The curves sometimes get worse with time, leading to malaligned positions of the back, rib cage, and hips. If the curves get too bad, they can cause serious health problems. And the kids usually don't like how the spine curves affect the looks of their bodies.
Doctors often prescribe special braces for kids with scoliosis to wear during their adolescent years. The most commonly used form of brace is called a thoracolumbosacral orthosis (TLSO). However, the research is unclear about how much the TLSO actually helps prevent the problems of scoliosis. To shed some light on this question, these researchers studied the medical records of 24 girls with adolescent idiopathic scoliosis. The girls all had significant curves and wore the TLSO brace 23 hours a day on most days. The researchers set up a system to make sure that the TLSO was put on equally tight every day. The girls were examined before bracing, one month after bracing, and regularly for four years. The girls were also examined at age 20, after they had finished using the TLSO brace. As part of their exams, special X-rays were done to show spine curvature from different angles.
The results showed that the TLSO brace did have a positive effect on the progression of scoliosis. In most cases, it corrected the twist in the spine. Most of the girls showed improvement in the alignment of their spine and ribs when they were wearing the brace. Significantly, only 12.5% of the girls needed surgery during the four years of the study. Bracing did not affect all the variables the researchers measured for, but it did improve or maintain several measurements. Many of the girls' bodies looked better because they had better alignment when viewed from the front.
The story was somewhat different at age 20. By that time, measures of the spine and rib alignment in almost all of the girls was equal to their measurements before using the brace. This means the brace kept nearly all the girls' spines from bending over the years. It is likely that their curves would have gotten worse without the use of the brace. The results of this study are better when compared to studies of other types of scoliosis braces.
When scoliosis is identified in girls after they have started their periods, the curves don't tend to get progressively worse. This is because the curve may be mild to begin with, and these girls are nearly done growing. These researchers also found that girls with curves in their lower back saw better correction soon after starting to use the brace. Girls with curves in the middle back showed steady correction throughout the four years.
Researchers don't know why these factors are true. But findings such as these can help doctors better understand the how scoliosis progresses and how to treat it.
Panagiotis Korovessis, MD, et al. Effects of Thoracolumbosacral Orthosis on Spinal Deformities, Trunk Asymmetry, and Frontal Lower Rib Cage in Adolescent Idiopathic Scoliosis. In Spine. August 15, 2000. Vol. 25. No. 16. Pp. 2064-2071.
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