Don't Assume a Curve is Progressing

[LindaRacine]

Hi...

We had a patient today. She was a 17yo, who had been measured ~3 years ago, with a 25 degree curve, and who wore a brace faithfully for a few years. When her parents moved a year ago, they went to a new specialist who told her she could stop wearing the brace. It was unclear to me, when she actually stopped wearing a brace, but she is no longer wearing it. They came in today, because they were certain her curve had increased, based on how her body looked. We took radiographs, and found that her curve was 24 degrees. Wish I had taken a moment to ask them what, specifically, made them think her curve had increased.

So, while I think it's a good idea to have your child checked if you notice changes, you shouldn't automatically assume that there's actually a change.

Regards,
Linda

[rohrer01]

My guess is that if the parents really did see changes in their daughter, then it is probably due to rotation. I think that is hard to compare on x-rays, but I could be wrong. Did the girl bring in her old x-rays? When I say I am progressing, it is based on what the doctors say when they compare from time to time. Interesting, though. If it isn't rotation, then maybe the girl had postural changes and the parents were used to seeing her posture in a brace.

[LindaRacine]

Yup, we had the old x-rays, and the Scoliometer readings were identical to last time.

[LokanasDad]

Or it is possible that they 'saw' it because they were looking for changes. So any little thing gets amplified in their minds. And a slight difference in how the daughter stands, or a quite natural curve of the body gets seen as a progression because that is what they fear most and are looking for.

[LindaRacine]

Or it is possible that they 'saw' it because they were looking for changes. So any little thing gets amplified in their minds. And a slight difference in how the daughter stands, or a quite natural curve of the body gets seen as a progression because that is what they fear most and are looking for.

I think that's exactly it.

[Ballet Mom]

You should ask them if they read this forum. I can imagine anyone reading here could get the impression that bracing doesn't work and that all scoliosis curves progress after maturity, which is not true, of course.

[rohrer01]

Ballet Mom,
Why do you ask this? She obviously didn't progress as her parents feared. If they feared progression, then they obviously felt the brace was helping to prevent progression. Maybe the child couldn't handle it because it was too painful.

[Ballet Mom]

Ballet Mom,
Why do you ask this? She obviously didn't progress as her parents feared. If they feared progression, then they obviously felt the brace was helping to prevent progression. Maybe the child couldn't handle it because it was too painful.

I replied as I did because people read the internet for medical advice and information on their or their child's condition. If they read here, they will probably come to the conclusion that even if the bracing was successful at stopping the curve, the progression will continue after the bracing has stopped. It is repeated quite frequently here by a poster.

Think of all the people who read this and become paranoid about their condition and rush off to have x-rays taken because they believe the poster and think they are progressing.

The belief that a curve will continue to progress after bracing, no matter the size, is a misconception that I have tried hard to respond to on this forum because I personally think it's a disservice to patients and their families.

[LindaRacine]

You're not making any sense.

This kid wore her brace, and her curve didn't progress. The only one reading something into that is you.

[rohrer01]

I replied as I did because people read the internet for medical advice and information on their or their child's condition. If they read here, they will probably come to the conclusion that even if the bracing was successful at stopping the curve, the progression will continue after the bracing has stopped. It is repeated quite frequently here by a poster.

Think of all the people who read this and become paranoid about their condition and rush off to have x-rays taken because they believe the poster and think they are progressing.

The belief that a curve will continue to progress after bracing, no matter the size, is a misconception that I have tried hard to respond to on this forum because I personally think it's a disservice to patients and their families.

I guess the hard thing is, is there is no clear cut answer on this topic. It works for some, and others it doesn't. No one knows why. I'm in the adult progression category, but I was never braced. However, had I been braced and ended up with the curve that I had, they would have considered that a success. On the other hand, I subjected myself to a treatment, in an effort to reduce my pain, that I believe caused the progression to start. So it could have a lot to do with what a person chooses to do, or how they manage their curves in adulthood, whether or not they progress. It could also have to do with whether a person is prone to premature arthritic changes and therefore their AIS progresses as degenerative scoliosis but is still classified AIS because they had it as a kid. Who knows? There are so many factors. I do see your point, but I don't think this thread was meant to be a catalyst to the brace/no brace controversy.