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  1. #1
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    First shot across the BrAIST bow...

    Here is a presentation in the upcoming SRS meeting this September in Prague...

    http://www.srs.org/UserFiles/file/am16-prelim-4web.pdf

    Paper # 102 Is the Story Over: Progression After Bracing in AIS
    Rachel Mednick Thompson, MD; Elizabeth Walker Hubbard, MD; Don Virostek; Lori Ann Karol, MD

    ---------

    They are starting to ask the question of what is the failure rate after bracing "success"?

    Take the BrAIST study where bracing "success" includes kids with a up to a 49* curve with up to 25% growth remaining. You read that right... a child with a 49* curve with 25% growth remaining was counted as a "success" in BrAIST. We don't know how many "successes had large curves with growth remaining because the authors DID NOT publish the curve magnitudes at the end if you can believe it. This might be the only published study that failed to do that. And yet it is ironically viewed as a hallmark study.

    Anyway, just knowing that alone and all by itself we can bet our bank account that the failure rate after bracing "success" is non-zero. The question is how far from zero is it? Dropping out half the kids who wore the brace needlessly (some of whom do progress after the brace treatment), few/some/most of the bracing "successes" will eventually be classified as failures. It is possible that between the kids who wear and brace and progress later after skeletal maturity, and the kids who don't wear a brace and progress later after skeletal maturity, it would be very informative to eventually know what percentage of kids in the bracing range are going to need surgery no matter what they do or don't do. That's what kids and parents need to know.

    The point is BrAIST can be halted early in dramatic fashion and can claim victory but the question of progression after bracing "success" is still obviously wide open. 23/7 Bracing is so difficult that most kids will do it only if it helps then avoid surgery for life. That is exactly what is being questioned and kids should be told.
    Last edited by Pooka1; 07-02-2016 at 08:35 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

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