Children and teens with adolescent idiopathic scoliosis (where the cause of the spine curvature is unknown) might be able to avoid spinal correction surgery if they wear a back brace, according to a new study that involved a trial considered so successful by researchers that it was able to be stopped early.
The research, published in the New England Journal of Medicine, also showed that the more a teen wears the brace -- at least 13 hours a day, if not more -- the less likely the spine curvature will reach a point where surgery is necessary.
"This study definitely shows braces work and are effective in preventing the need for surgery," study researcher Stuart Weinstein, M.D., a professor of pediatrics and orthopedic surgery at the University of Iowa Children's Hospital, said in a statement. "Children who are at risk should be treated with a brace, and they should wear it at least 13 hours a day for it to be effective."
While bracing has long been used as treatment for scoliosis -- a condition where the spine curves in an "S" or "C" shape, instead of the typical "I," which can lead to rotation of the spinal bones -- researchers noted that there had been no definitive answer as to whether bracing could prevent the need for surgery.
"The efficacy of bracing was never really proven," Weinstein said in the statement. "I wasn't sure if braces really worked or not, and I've treated thousands of patients."
The new study included 242 patients, 116 of whom were randomly assigned to either receive a brace or only undergo observation (which involved no interventions), and 126 of whom were given the opportunity to choose whether they wanted a brace or to only undergo observation. Of those who wore the brace, they were instructed to wear it for at least 18 hours a day. The researchers considered spine curvature of 50 degrees or more by the time of skeletal maturity as the indicator that the bracing wasn't working to prevent spinal correction surgery (since this is the extent of spinal curvature when surgery starts to be recommended).
The participants joined the study sometime between March 2007 and February 2011, but the study was cut short in January 2013 when the efficacy of the bracing became clear to researchers. They found that 72 percent of those who chose to undergo bracing experienced success in preventing further spinal curvature, compared with just 48 percent in the observation group.
And those who stayed committed to wearing their braces for at least 13 hours a day experienced extremely high success rates, of 90 to 93 percent.
Adolescent idiopathic scoliosis is not terribly uncommon, affecting somewhere between 2 and 4 percent of kids ages 10 to 16, according to a 2001 article in the journal American Family Physician.
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