Q: Providence vs. Charleston -- What's the story?

[Green321]

Hi -- I am trying to understand the difference between Charleston and Providence braces.

In specific, I'm trying to learn whether one brace tends to be used for certain kinds/types of curves...

Our story: My child had a hemivertebrae excision (in the lumbar section) a while back and, for a while, it was smooth sailing. Now, however, child's back is starting to curve again (above small lumbar fusion.)

Nightime braces are being looked at by child's doctor (as way of slowing down progression while 'watching/waiting' to see if curve will stop on its own.)

Both types of brace (Charleston and Providence) were mentioned as possibilities...

I would really appreciate any info/comments people can share on:

-- Differences between Charleston and Providence braces
-- How (i.e., for what kinds of curves or situations) they tend to be used
-- Effectiveness
-- Anything else you care to share.

Thanks!

[concerned dad]

There was some discussion recently about these braces on the research forum here

[mymollybt]

Our ped. orthoped wasn't keen on either of those braces. We still mentioned them to our orthotist though and I only know what he told us. We were very interested in both of these night braces for our daughter who is 8 and has a 24 and 20 degree S curve. He discouraged them saying that both braces truly work best on single curves even though the Providence is marketed as a nighttime brace that works on double curves. We wound up going with the Wilmington Brace and are doing a 12-13 hour per day schedule. She puts it on usually at about 7 or 8pm and takes it off the following morning. We just had our in brace readings and it is acheiving a 10 and 10 degree result. Obviously we are crossing our fingers that this schedule will hold her curve.

Again, that was only our orthotist's (whom I think is very respected and very good) opinion. He says they are wonderful braces for single curves - not so wonderful for doubles.

[Green321]

Thanks. Am trying to understand the thinking as to whether certain braces can contribute to the development of compensatory curves.

Out story: Right now, my child only has lumbar curve, which has started progressing again after surgery two years ago to remove hemivertebrae...

For a while (almost 2 years) it was smoothing sailing (i.e., the curve was 'fixed.') , but now it has started progressing again, above the lumbar fusion. It's not a massive problem yet, but definitely seems to be on the move...

As a result, Doctors are considering nightime braces as way to slow down curve while 'watching and waiting.'

Here's the hook: As I understand it, there is apparently a concern that a Charleston braces can cause, or contribute to, the development of an upper compensatory curve -- and that a Providence is less likely to do that (i.e., cause a second curve.)

I am not sure if I have that (above) right, though...

I know there's no "pat" answer to any of this, but am grateful for any info/insights anyone may have.

[leahdragonfly]

Hello,

I am sorry to hear you are having to reconsider bracing after surgery. Here is a link to the Scoliosis Research Society's Bracing Manual, which I have found very informative:

http://www.srs.org/professionals/bracing_manuals/

You will find sections about each of the brace types you are inquiring about. My young daughter wore a Providence for a few months (along with a boston for part of the day). My understanding of it is that it is a hyper-corrective brace which attempts to achieve a greater level of correction when the child is laying down in bed. It is not a bending brace per se. Our daughter's in-brace curve was decreased from 26 degrees thoracic to (-3) degrees IN BRACE, so it definitely gave her an agressive correction. The Charleston is different, it is a bending brace, which attempts to actually bend the child out of their curve so to speak. Check out the bracing manual for full details of this.

Your orthotist may be able to give you more info and recommendations about which brace might work better for your child's particular situation.

Good luck,

[Green321]

Thank you very much

[cmlsoccergirl]

Hey! I dont know how much help i could be but i wear a providence brace myself, I dont know anything about the other brace though. You wear this brace at night, strickly only when you sleep, its very uncomfortable if you try doing anything else in it.

I have been braced for 7 months and my curve has stopped and they cant tell if its permanent but its not getting worse.

I wish your child the best! I know this can be pretty difficult to go through

Courtney

[Green321]

Thanks Courtney -- it's great hearing from people with first-hand experience.

Glad to hear your brace is working.

[SLS]

My 13 y/o daugher has been in a Providence Brace since she was diagnosed last fall. Her stats are:

Thoracic Curve Degree:
T5 - 11 = 31%

T11 - L4 = 44%


Lumbar Curve Degree:
L4 - S1 = 27%



Alignment:

4.5 to 6 cm off center

Her Risser is a 4. The brace has prevented any progression. Since she was braced, there has been absolutely no change. We are going for Schroth Thereapy for two weeks in June at the recommendation of her orthopedic. We are very hopeful.

Back to the brace, she has no problems wearing it at all. In fact, if she misses a night, or for the three nights she can't wear it before an x-ray, she has a hard time sleeping!

[Green321]

Thank you -- it sounds like the Providence is working well.