New Boston Brace Wearer

[briannasmom]

My ten year old daughter just got her Boston Brace last week. Her curves are 40 degrees(top right) and 34 (bottom left) so that to the layman's eye you would never know she has scoliosis. She also never had any pain. She was diagnosed an orthopedist decided to take a base line x-ray (even he didn't think the curves would be so bad) My daughter is adjusted really well to wearing this thing. She is up to 18 hours a day. Eventually she will have to wear it 23 hours a day. Everytime I look at her though, my heart breaks! She is so young to be stuck wearing this thing! I have also heard that Boston Brace's usually don't help for curves 40 degrees and over. Did anyone else every hear that? Any advice for a new brace wearer and her mom?

[LindaRacine]

Hi...

I think it depends on the type of curve, but I have also heard that kids with larger curves generally cannot be successfully braced. Here are abstracts of some studies:

Spine. 2001 Nov 1;26(21):2354-61.

Factors that influence outcome in bracing large curves in patients with adolescent idiopathic scoliosis.

Katz DE, Durrani AA.

Orthotics Department, Texas Scottish Rite Hospital for Children, Dallas, Texas 75219, USA.

STUDY DESIGN: A retrospective review of 51 patients with adolescent idiopathic scoliosis (AIS) treated with a Boston brace for curves ranging from 36 degrees to 45 degrees. OBJECTIVES: To determine what radiographic or clinical observations may be predictive of outcome. SUMMARY OF BACKGROUND DATA: Patients with AIS who are braced for curves >35 degrees are less likely to respond to conservative treatment than patients of similar maturity with smaller curves. METHODS: Skeletally immature patients with AIS with no history of prior treatment were treated with a Boston brace. Cobb angles, vertebral tilt angles, coronal decompensation, apical vertebral translation(s), apical vertebral rotation, lateral trunk shift, rib vertebral angle difference, pelvic tilt, and the lumbar pelvic relationship (LPR) were measured at brace prescription, initial in-brace, brace discontinuation, and follow-up. RESULTS: At the time of brace discontinuation, 31 patients (61%) were judged treatment successes. With follow-up observation, an additional eight patients progressed beyond 5 degrees, and a total of 16 patients (31%) required surgical correction. Only patients with double curves were found to have radiographic values predictive of outcome. The LPR angle, the association between the thoracic curve vertebral tilt angles and the amount of in-brace correction of the Cobb angle, were significant predictors. A patient's reported wear schedule significantly influenced outcome. CONCLUSIONS: Patients with a double curve pattern in which the thoracic curve is >35 degrees and the LPR angle is >12 degrees are significantly more likely to demonstrate curve progression. In-brace correction for double curves of at least 25% and a patient's ability to wear the orthosis >18 hours/day significantly increased the likelihood of success.

Spine. 2000 Sep 15;25(18):2326-32. Related Articles, Links

Effectiveness of the boston brace in treatment of large curves in adolescent idiopathic scoliosis.

Wiley JW, Thomson JD, Mitchell TM, Smith BG, Banta JV.

Division of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.

STUDY DESIGN: This is a retrospective study of 50 patients with adolescent idiopathic scoliosis with curves measuring 35 degrees to 45 degrees who were treated with a Boston brace. OBJECTIVES: The purpose of this study was to determine whether the Boston brace could effectively halt long-term progression in skeletally immature adolescents with idiopathic scoliosis who had a curve between 35 degrees and 45 degrees. SUMMARY OF BACKGROUND DATA: The Boston brace has been shown to be effective in preventing curve progression in adolescent idiopathic scoliosis, but its efficacy in large curves has not been fully studied. METHODS: Fifty adolescents were treated with a Boston brace for idiopathic scoliosis curves of 35-45 degrees (mean, 38.55 degrees ). All were judged to be skeletally immature based on menarcheal status (mean, 2.6 months before menarche), Risser sign (mean, 0.90; range, 0-2), and chronologic age (mean, 13 +/- 1 years). Patients were recalled for long-term follow-up at a mean of 9.7 years (range, 6.23-13.22 years) after brace discontinuation. Three well-matched patient subsets were then identified based on compliance. Group 1 (n = 24) consisted of patients who were compliant with the brace program and wore the brace 18 or more hours per day, Group 2 (n = 14) contained patients who wore the brace 12-18 hours per day, and Group 3 (n = 12) contained patients who wore the brace 0-12 hours per day. RESULTS: There was a significant difference in the amount of initial correction seen in the brace between the groups: 49%, 45%, and 33% curve correction in the brace for Groups 1, 2, and 3, respectively (P < 0.05). At long-term follow-up there was a statistically significant difference between Groups 1, 2, and 3 in the percentage of patients in whom the curve had progressed to more than 45 degrees (P < 0.001), who had more than 5 degrees of curve progression (P < 0. 05), or who had undergone posterior spinal fusion (P < 0.001). CONCLUSIONS: These long-term data confirm that the Boston brace when used 18 or more hours per day is effective in preventing progression of large curves at a mean of 9.8 years after bracing is discontinued.

--Linda

[MadamMim16]

Hi! I have a Boston brace too and also wear it for 23 hours a day. My curve was 23 degrees bottom and 17 degrees top. After wearing it for a while, i went to get an x-ray and my bottom curve is 8 degrees and my top is 11. I never heard of anything about Boston Brace not helping for 40 degrees and over but i hope it helps you guys!! GOOD LUCK Temima

[briannasmom]

Thanks for the positive information!!

[nicoles mom]

Hi
I Guess For Some It Works It Didn't Hold My Nicole Curve. My Daughter Nicole Was Diagnosed When She Was 10 Years Old She Was 29 Top 28 Bottom. She Also Had No Pain. No Brace Needed Was Told To Come Back In Six Months For Another Xray.three Months Pasted. I Decided To Take Her To Another Doctor His Xray Showed Her Curve Moved Now 33 Top And 31 Bottom. He Put Her Into A Boston Brace 18 Hrs A Day. Six Months Later It Was Holding.than She Had A Growth Spur At The Next Visit She Had To Wear The Brace For 23 Hrs. After That The Curve Just Keep Going. She Wore Her Brace 23 Hrs A Day For 1 1/2 Years. She Had Surgery March 30 2005. She Was 58 Top And 55 Bottom. After The Surgery Shes 19 Top And 39 Bottom. They Also Have Her Back In The Brace 20 Hrs A Day To Hold Her Lumbar. My Heart Breaks For My Daughter Too. She Hates Her Brace And Can't Wait Till They Tell Her She Doesn't Need It.
We Did Meet Another Girl Who Wears A Boston Brace Her Curve Is Holding With Wearing The Brace She Is Also In The 40s. Her Mom Told Me The Doctor Says She Is Almost Done Growing So She Would Not Have To Wear It Much Longer...so Hopefully Your Daughter Will Do Well Wearing The Brace.
Theresa

[marmyte]

my brace held my curves (and even decreased my thoracic one a bit - the thoracic curve in my case was the compensatory one so more likely to decrease through bracing than the lumbar one) and it meant i could wait until i had surgery. i wore my brace for just over 18months then waited another 18 months until i had surgery. sometimes it works, sometimes it doesn't, but i think persevering is the right thing to do - some appointments you see a progression, others you may see a correction

[KRIS ATKINSON]

My daughter wore a brace for almost 2 years, starting around 40-45 degree curve. We were warned it would be iffy as to whether the brace would help at the time, but we decided to at least try to prevent her curve from increasing as much as we could with the brace. It ended up helping her get some more growth before surgery, so I don't regret her wearing the brace. In our case, her curves changed very quickly. If it had not been for the drastic change is curvature, she would have been fine with wearing the brace until her spine stopped growing, just to avoid surgery and prevent a life-threatening curvature. We decided if her curve got around 65 degrees or so and looked to be continueing, we would advance the need for surgery. That ended up happening. However, if she could have worn the brace from age 13 at curve 40 to age 17 at 60, and have the curve stop at 60 or so, she would have stayed with the brace and the "aches and pains" from the stress on her muscles from the scoliosis. Good luck! God bless! Kris

[SpineWhine]

I wore a Boston Brace as a teenager, and Ithink it just slowed down the progression of my curve while I went through some growth spurts. THe hardest thing was trying to be fashionable without my brace showing. And tying my shoes - boy I remember having to adjust to lots of little things. I would let the teachers know that she is wearing it, to avoid issues and unfair expectations at school. I once was yelled at because I couldn't put my head on my desk like the other kids. Ummm... I couldn't bend like that in my brace, I wasn't being cheeky! GOod luck to your daughter, even though she may feel different sometimes, it will only make her stronger (physically and emotionally) in the long run!

[violinprincess3]

hi

i started wearing a boston brace 12 hours a day when i was around 8 or 9, the summer before 5th grade. i also wore a brace (don't recall the type) after my scoliosis surgery for 6 months all the time with exception of getting a shower. i've never heard about boston braces not helping larger curves, but braces generally don't work as well on larger curves.

as for advice, just try to buy some looser clothes for your daughter, especially pants because they have to fit over the brace. just try to make sure she wears it as much as possible because that way it will be more effective and hopefully correct your daughter's curvature. good luck!

[mzl]

My 12 yr old dtr also has the "perfect S curve" which wasn't detected until x-rayed. It was quite a shock for us...especially her Dr... she's been in the brace almost a year now. Does it work? It keeps the curves from progressing IF SHE WEARS IT! Unfortunately, she didn't wear it in sleepaway camp- nobody notified me, and we let it slip for the summer-she came home having gone from 38 to 44 degrees. Now she's in the brace diligently wearing it, but she wants to have surgery.

It does break my heart to see her going through this... she feels like her body is in jail, and that the brace is leaving emotional scars on her life... yet surgery is not like putting a band-aid on... it's very serious. On the other hand, we don't want our dtr to go through life with chronic back issues, like her great-aunt and other family members have in their later years. So we're supporting her and taking this all one day at a time...

Her older brother also developed rapidly increasing angles w/growth spurts, is braced and doing PT. It's a burden upon these wonderful children, and I just want to make them feel comfortable, grow up without pain, and be able to face life with confidence and love in their hearts.

[ihatescoliosis]

My ten year old daughter just got her Boston Brace last week. Her curves are 40 degrees(top right) and 34 (bottom left) so that to the layman's eye you would never know she has scoliosis. She also never had any pain. She was diagnosed an orthopedist decided to take a base line x-ray (even he didn't think the curves would be so bad) My daughter is adjusted really well to wearing this thing. She is up to 18 hours a day. Eventually she will have to wear it 23 hours a day. Everytime I look at her though, my heart breaks! She is so young to be stuck wearing this thing! I have also heard that Boston Brace's usually don't help for curves 40 degrees and over. Did anyone else every hear that? Any advice for a new brace wearer and her mom?

hi i have a 42 and 47 degrees and i am wearing a boston brace too i am 11 eventhough it mite say that i am 14 i also heard that it daoesn't usually work. i just got mine 4 days ago and it's not going too wonderful but i think that you should not worry about surgery yet there is still a good chance 4 u