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Hannah1
07-13-2005, 11:04 PM
Hi. My DD is 14 and just started with a new md because the old one retired. Her latest is that she has a 21 degree curve and a 1.5 Risser. The doctor said that the radiologist we went to measured the curve as 28, but the orthopedist thinks it's 21. I heard some doctors will brace at 20 if the Risser is below 2 and will do a night brace. My orth. said she does not believe in bracing until 25 degrees. I am so confused!

spincon58
07-13-2005, 11:36 PM
Hi,
One thing my doctor always told me ;when reading xrays, there is a plus or minus 5 percent margin of error...you could do a few things...get another opinion...and have another physcian measure the curve...you could wait a few months and than xray again....my daughter had her first measurement, it was 12, it than jumped to 19 in 2 months, than to 25 ...she was promptly braced...after 3 months wearing the brace the curve shot down to 5 degrees......we have a very strong family history of scoliosis....I just had surgery one year ago to correct a 53 degree progressing curve..my eldest daughter has a 28 degree curve, my son has a 16 degree....I'm very happy with the results of my youngest daughter who is wearing her brace 16 hours a day....also do plently of reading and educate yourself so you can make the best informed decision for your daughter...good luck.....

Bamaro
07-14-2005, 10:09 AM
Went through some of the same issues with my daughter. Different docs came up with different measurements between 20 & 25deg. The more experienced docs measured higher so we went with bracing. All the docs agreed though not to brace before 24deg.

orthotist
07-20-2005, 02:20 PM
Hello,
It's ok - I agree, it can be confusing. Doctors can vary in their prescription for bracing, as they do with many diagnoses (hence the popularity of second and third opinions). There are natural history studies about scoliosis that can give us an idea about the chance for scoliosis to worsen based on Age, gender, Risser sign, size of the curve, type of curve pattern, etc. In other words, there are a lot of variables that influence curve progression.

In my experience, docs usu. brace curves in Risser 0,1,2 curves after they near 25 degrees, esp. if there is a history of seeing the curve get bigger. The cobb angle that determines the degrees of the curve is not a perfect measurement - depending on where u look in the literature, it can have 2-5 degrees of error in measuring it (to the high or low side) . In your case, it's a bit higher.

Other variables listed above and other intangibles like family history, psychology, family or patient preference also may influence a physician to prescribe bracing earlier than 'textbook' guidelines or later or not at all.

My suggestion is if in doubt, always to get a second opinion. Note, in general, part time bracing not as effective as full time bracing, and there are some basic guidelines when part time bracing is a feasible option.

Hope this helps.