When considering scoliosis braces as a treatment option for scoliosis, it is important to understand that the success or failure of bracing treatment often comes down to three things.
1) The correct type of brace is fitted for the type of scoliosis
2) The brace is fitted by a competent and accredited bracing provider
3) The patient wears the brace as recommended and is reviewed regularly
The aim of scoliosis bracing is to stabilise the curve, attempt to prevent further progression and ideally to make some correction to the curve. Correction is not always possible, and is more likely to occur in cases where the patient is in their teens or pre-teens while their spine is still growing. This is why the best outcomes for scoliosis cases occur when the scoliosis is detected and treated as early as possible. Adults with scoliosis can be successfully treated with bracing for pain and poor posture caused by the scoliosis. In cases where the adult spine is very flexible, it may be possible for a brace to make a small reduction, but as a general rule improvements in pain and posture are the main goals in treating adult scoliosis.
Two main types of scoliosis braces are available: flexible dynamic braces, such as the SpineCor scoliosis brace, and hard plastic braces, such as the Gomez TLSO.
SpineCor Scoliosis Brace
The SpineCor brace is a lightweight, flexible brace developed in Montreal, Canada by a team led by orthopaedic surgeons, Dr. Charles Rivard and Dr. Christine Colliard. The success of the SpineCor brace has been documented and researched since 1992 and some of the best supporting research on it was published in 2007 in the Journal Of Pediatric Orthopaedics [June 2007, P. 375-379]. There are only two papers published which dispute the efficacy of the SpineCor brace, however on close inspection the clinicians used in these studies were not certified to administer the brace and the authors were associated with a competing product, so the results are questionable and if anything prove the point that the brace needs to be fitted by a competent and accredited clinician.
The SpineCor brace is different to traditional hard plastic braces because it works on dynamic principles. Rather than trying to force and hold the spine in place, it works with the spine and muscles to gradually change their position over time. The key benefits of this approach are:
1) The SpineCor brace is more comfortable so patients wear it more often and are more compliant.
2) By allowing freedom of movement, the muscles do not weaken over time, as often occurs in hard braces
3) The spine can also move freely so it doesn't become stiff over time
4) The SpineCor brace can be worn during exercise and recreational activities
5) The SpineCor brace is barely visible under clothing, which helps with self-image; especially in teens
6) The SpineCor brace can be used to treat adolescent idiopathic scoliosis, some types of congenital scoliosis, and also adult scoliosis.
Gomez Asymmetrical TLSO (Thoraco-Lumbar Spinal Orthosis)
The Gomez Asymmetrical TLSO is a hard plastic brace invented by orthopaedic surgeon, Miguel Gomez. The brace is custom made for each patient using a 3-Dimensional assessment and computer assisted design and manufacture (CAD-CAM) system. Unlike some other hard plastic braces, the Gomez brace attempts to correct the spinal deformity in all 3 planes with a focus on overall spinal balance and stability. Most rigid TLSO systems rely on traditional plaster casting of the patient and x-ray. The use of CAD-CAM allows greater manipulation of the brace in all three planes prior to production. The Gomez Asymmetrical TLSO is mostly used for infantile, juvenile and adolescent idiopathic scoliosis treatment, but in some cases it can be used in non-idiopathic cases such as congenital and neuromuscular curves. The Gomez brace can be used as a treatment in its on right, with physical therapy or as an initial treatment for larger curves with a view to switch to dynamic bracing when the curve is more manageable.
Which is the best Scoliosis Brace?
While there are many types of scoliosis braces on offer, the SpineCor scoliosis brace and the Gomez TLSO are both proven, effective treatment options for scoliosis bracing.
The only way of determining which brace is the best option for a patient is to have a thorough examination conducted by a clinician with expertise in these scoliosis bracing systems. A good examination will include a postural examination, assessment of spinal flexibility, and x-ray analysis. It is advisable to ensure that the clinician offers more than one type of brace as this will give the patient a greater variety of treatment options. It is also important to make sure the clinician is fully accredited to provide the brace.