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Thread: The Braist Study

  1. #286
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,901
    Maria, I agree Dr. Hey has a pragmatic approach which probably springs from seeing all the "bracing success stories" walk into his office in surgical territory.

    I fear that the BrAIST study will ratchet the browbeating to wear braces up several notches which will set up some very bad family crises if/when it goes south later in life. As things stand now, it hasn't been ruled out that bracing only delays surgery for most if not all patients that is does anything at all (leaving aside the masses of kids unnecessarily braced).

    I have been thinking about something... considering just the kids who wore the brace more than 13 hours (or whatever it was) and achieved a ~90% "success" rate of not reaching 50* by maturity. Leaving aside the issue of exactly how large their curves were (specifically how many were >40*), we know that at least half those kids who happened to wear the brace that long each day on average were unnecessarily braced. So leaving aside the small sample size, while it might be true to suggest to a child that ~90% of kids who wore a brace 13 hours a day did not reach 50* at maturity, there is still half a chance they wouldn't have reached that if they didn't wear a brace.

    This is no easy decision even after BrAIST as Dr. Hey makes clear.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  2. #287
    Join Date
    Mar 2010
    Posts
    2,004
    Parents should to think first of all in facts.

    This last braist study definitely showed the brace effectiveness in order to reach maturity under the surgical range, so chances to end over that range are greater without bracing and doing nothing else.

    Probably something as Torso Rotation or shift-side exercises may have the same (or even more) effectiveness than braces and surely are less traumatic solutions, but about braces effectiveness, it could be say there is now a recognize scientist proof.

    There is no way yet (as I know) to know if progression would ‘spontaneously’ stop or not, but is now known that if the curve is predetermined to progress, there are good chances to stop it with brace, at least until the end of growth. So if nothing is done, there are important chances to reach maturity over surgical range.

    About chances to remain under surgical range until end of life (not only end of growth), there are not yet a recognized study also including (as this braist study did) some phrase as this: ‘No potential conflict of interest relevant to this article was reported.’
    Nobody said as I know that braces cannot be combined with other non surgical solutions, making it even more effective, that is, reaching maturity with even less degrees.

    There is a reason about why some times braces works and sometimes not and it seems that time in brace is not the only one. Flexibility and reduction in brace are probably at least ones of those reasons.

    Except The Spinecor (if we see it as a brace), La Brace, Cheneaut and Milwaukee (Am I forgetting someone else?) all current braces are very similar to the most used since thousands of years ago, but it seems that some experimental braces are arising http://www.ncbi.nlm.nih.gov/pmc/arti...MC3490735/#B38
    Also some other braces rediscovering the (‘antigravitatory’) distraction principle seems to be arising.

    So what kind of brace should to be used, combined with what other kind of solution or not, reaching or not some conditions before use it (as flexibility) and how, achieving the greater reduction in brace or not.. are surely not all simply but all necessary issues that should to be evaluated in every case.

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