More Good Evidence Bracing Works in AIS

[Ballet Mom]

If, as a parent, I knew this piece to the puzzle, AND I had insurance coverage for my child, I would opt for surgery. Many young adults and many older adults don't have insurance or adequate insurance. Again, we come into the realm of what Linda stated earlier of being responsible young people and choosing carreer paths that will give them good coverage. But realistically, most young adults don't think past tomorrow, it's in their brain development. Most young people think "it will never happen to me". That's why we have so much alcohol and drug abuse, even among the so-called "responsible" young people that opt for college educations. So to me, it kind of sounds like passing the buck. Instead of the parent taking control of the issue when their child is covered by insurance (even if they are not covered, groups like Shriners will take care of the kids without insurance), they just postpone it and push it into the realm of making it their childs responsibility when they grow up. I know no one consciously thinks that way, but that is what is basically happening if you are just postponing an inevitable surgery. I don't see many charity groups out there that are willing to help adults, because we are supposed to be "responsible" and take care of ourselves. Sadly, poverty remains. There are more poor people out there than rich people and the adults that could have been helped as kids are left to suffer.

So what are you proposing for the kids who get fused and then need revision surgery in twenty years and don't have insurance? Or the kids who were below surgical levels and progressed in life and need to get surgery, but they don't have insurance either?

The revision surgeries are half a million to a million dollars...how are they going to get paid for? How are the ones left in pain going to get pain meds when they're poor and have no insurance?

[Ballet Mom]

It's also misleading because they are comparing people with surgically-treated scoliosis to normal people as controls. They should be comparing to people with non-surgically-treated scoliosis. Of course some of those people are probably too disabled or dead from non-surgical treatment so it might be hard finding folks.

Now there is still value in this study but the danger of publishing this work is that alternative treatment purveyors largely do NOT understand that the appropriate comparison is to other people with scoliosis and so routinely misrepresent studies like this to innocent patients as a reason not to get fusion surgery. It's risible.

It's good for people to understand that fusion surgery is not the miraculous "cure" that you like to make it out to be. There are demonstrable deficiencies with it. Kids should understand this when they are diagnosed so they can make decisions that will help them through their growth with the lowest curve possible.

[rohrer01]

It's good for people to understand that fusion surgery is not the miraculous "cure" that you like to make it out to be. There are demonstrable deficiencies with it. Kids should understand this when they are diagnosed so they can make decisions that will help them through their growth with the lowest curve possible.

I agree that surgery isn't a cure. There isn't a cure for this disease. There are only treatments. Even looking at the before and after x-rays, most people are still left with scoliotic curves and are now fused that way, although progression is usually (not always) stopped. That is something to think about. On the other hand, many people having surgery get enough correction to reduce or even eliminate their pain and stop the crushing of their internal organs.

Here's another question to think about? How many of the braced population have painful curves?

If I were told that a brace would stop progression until maturity but I would still be left with pain and would likely have to have surgery as an older person, I definitely would not do it. But if I were told that the brace would stop progression to maturity and reduce or eliminate pain for a prolonged period of time but I may still require surgery later, I would probably do it. It's about quality of life for me, as I'm sure it is for many others.

Unfortunately, I don't know if any doctor could accurately predict what will happen after bracing. The thing that I find very sad, and I've mentioned this before, is that once you're 18 they wash their hands of you, no matter what category you fall into (W&W or brace) and they consider themselves successful regardless of your quality of life. Too much emphasis on numbers and not enough on symptoms!

[Pooka1]

Unfortunately, I don't know if any doctor could accurately predict what will happen after bracing. The think that I find very sad, and I've mentioned this before, is that once you're 18 they wash their hands of you, no matter what category you fall into (W&W or brace) and they consider themselves successful regardless of your quality of life. Too much emphasis on numbers and not enough on symptoms!

Actually, although our surgeon only does pediatrics, he said my daughters will never age out and they can return to him. So not all kids are cut loose.

They are not expected to need any more contact with a spine surgeon but if they did, I would encourage them to see a revision specialist as opposed to a pediatric guy. And as he mentioned, though they are not expected to need any more surgery, on the rare chance they do, he would be long retired by then.

But at least he offered. It warmed my heart.

[Elisa]

In a weird way, I am glad that my son's situation was a "no-brainer". Even at that, the whole thing made me crazy! I feel for those who actually have a choice to make. It must be so tough.

[Pooka1]

In a weird way, I am glad that my son's situation was a "no-brainer". Even at that, the whole thing made me crazy! I feel for those who actually have a choice to make. It must be so tough.

I have always felt my one daughter who never wore a brace had an easier, quicker route through scoliosis than did her sister who wore a brace but still needed surgery. It isn't even a close call.

And just to remind folks, the one kid only had a night-time brace. I asked her if she would have worn a 23 hour/day hard brace and she said no. That is the correct answer until bracing is shown to be effective for particular people.

[Ballet Mom]

And just to remind folks, the one kid only had a night-time brace. I asked her if she would have worn a 23 hour/day hard brace and she said no. That is the correct answer until bracing is shown to be effective for particular people.

Surgery was the correct answer for you and your family. It is quite apparent that parental support is required to be successful in bracing. If a parent is so horrified by the prospect of bracing, they really should spare the child of bracing because the child will follow the parent's cue and it will most likely be a waste of time and effort.

I can't even imagine the arrogance it takes to presume to have decided on the correct answer for everyone out there.

I am also quite disgusted that this site is so anti-bracing that only a couple of bracing people dare to pop in here once in a while. And that this harrassment of bracers is allowed to continue. It's a disgrace quite frankly.

[Pooka1]

It's a disgrace quite frankly.

All the faith-based people whinge like that. Faith is NOT a way of knowing.

Evidence and science are the only games in town.

[Pooka1]

The Church of Bracing

Faith required. No evidence necessary.

Being cavalier is a virtue.

[Ballet Mom]

The Church of Bracing

Faith required. No evidence necessary.

Being cavalier is a virtue.

You are exactly what's wrong with science these days. You make your own conclusions that fits your pre-conceived ideas and then just try to force the data to force it down everyone's throats. I think "scientists" should be required to major in engineering first so they can learn to think for themselves instead of following the herd.

[Ballet Mom]

All the faith-based people whinge like that. Faith is NOT a way of knowing.

Evidence and science are the only games in town.

Such a prejudiced person. Shameful.

It's amazing that you can overlook the mutliplying evidence of the efficacy of bracing if used for the appropriate people, i.e. < 40 degrees with a certain amount of wear each day without psychological co-morbidities and having parental support.

[rohrer01]

So what are you proposing for the kids who get fused and then need revision surgery in twenty years and don't have insurance? Or the kids who were below surgical levels and progressed in life and need to get surgery, but they don't have insurance either?

The revision surgeries are half a million to a million dollars...how are they going to get paid for? How are the ones left in pain going to get pain meds when they're poor and have no insurance?

That is my whole point. Whether a child is braced or not it still stands to reason that they could need surgery later on down the road. Linda posted those couple of studies that fused people have no more lower back or pain issues than the general population. However, it didn't mention trouble with the fused region, but pain was still the same as the general population. I'm not against bracing, and my scenerios could never be known. Perhaps there are adults out there that didn't progress because they were braced. I don't know and it would be great if it were to be true. If told to wear a brace when I was a teen, I would have done it. I'm just saying that if fusion is inevitable, wouldn't anyone agree that it would be better to work with a young, healthy person with a flexible spine rather than an older, arthritic, osteoporotic spine on a less healthy person? Not to mention that the kids can get it for free even if their parents can't afford it. Poverty stinks, but it's out there.

[Ballet Mom]

That is my whole point. Whether a child is braced or not it still stands to reason that they could need surgery later on down the road. Linda posted those couple of studies that fused people have no more lower back or pain issues than the general population. However, it didn't mention trouble with the fused region, but pain was still the same as the general population. I'm not against bracing, and my scenerios could never be known. Perhaps there are adults out there that didn't progress because they were braced. I don't know and it would be great if it were to be true. If told to wear a brace when I was a teen, I would have done it. I'm just saying that if fusion is inevitable, wouldn't anyone agree that it would be better to work with a young, healthy person with a flexible spine rather than an older, arthritic, osteoporotic spine on a less healthy person? Not to mention that the kids can get it for free even if their parents can't afford it. Poverty stinks, but it's out there.

It is ONLY Pooka who claims that braced people all need surgery later on in life. I bet you couldn't find a single orthopedic surgeon to agree with her.

[rohrer01]

It is ONLY Pooka who claims that braced people all need surgery later on in life. I bet you couldn't find a single orthopedic surgeon to agree with her.

I don't think that is what she is claiming. It is my understanding that she believes the evidence in the papers that she has read to support the idea of bracing being inevitably the same as the watch and wait group later on down the line. More studies need to be done to prove this hypothesis, and I think she mentioned one that was being done. Her argument was that the doctors didn't find it unethical NOT to brace kids that would have normally been braced in order to conduct this study. Her claim, if I understand it clearly, is that if they (the doctors) didn't find it unethical to withhold bracing, then they (the doctors) don't really think bracing has any long term effecacy. I don't think anyone can claim that all braced kids go on to need surgery, but then again neither do all of the watch and waits. Pooka can correct me if I'm wrong. But that's what I understand her posts to mean, even though she may come across as rather harsh.

[Ballet Mom]

So basically, all the orthopedic surgeons who have seen my daughter, and all the orthopedic surgeons who are seeing other pediatric patients, and all the medical textbooks are all wrong and lying and Pooka in her ultimate wisdom knows better than anyone out there. They're all lying because they're hateful people who know that my daughter will probably need surgery when she's old and decrepit with co-morbidities and bad bones and probably won't be able to afford it because she'll probably be poor and without insurance. And that gives them great pleasure. It's no doubt a big conspiracy to hide the truth because they are trying to save insurance companies money by not paying for surgery now. No doubt there are kickbacks involved.

It's to laugh.