Should I Brace My Child’s Scoliosis?Document Transcript
Should I Brace My Child’s Scoliosis?Rigid brace treatment for adolescent idiopathic scoliosis is the most common nonoperative form of scoliosis treatment. There are two primary biomechanicaltheories adopted by brace treatment advocates. The first is that bracing willpassively unload the over compressed vertebrae and cartilaginous growth platesto induce less wedging deformity in the apical region of the scoliosis.The secondis that scoliosis brace treatment causes trunk muscle contraction which producesthe in brace correction. Most biomechanics experts would agree that spinalbraces do not produce muscle contractions that are corrective and that allcorrection is produced by passive forces acting upon the surfaces of the ribcageand pelvis.If we assume that passive external forces cause the in brace correction thenwhat makes us think that when the passive force is released that the spine willstay corrected? The answer is simple, it won’t. Muscles that support the spinalcolumn in gravity control the spines position. Children with adolescent idiopathicscoliosis do not have abnormal anatomy, wedged deformity. The musclesprimarily type I spinal multifidus have been found to be of different lengths inthoracic curvature most noticeably at the apical regions in the spine. The muscleimbalance derives from the neurological control in the brainstem and spinal cordresponsible for creating spinal balance in gravity. Therefore applying a scoliosisbrace to force the spine straighter will have no impact on the muscle lengthdifferences or the neurological command centers. In addition the addedgravitational support produced by the scoliosis brace will weaken the antigravitysystem yielding less support produced independent of the brace. Most post bracestudies have identified progression after the brace has been weaned. Scoliosisbrace experts have adamantly recommended that all braced children shouldperform spinal exercises routinely while weaning from a scoliosis brace to try andprevent this collapse process once the brace comes off.My concern with this process is that it doesn’t make any sense. Studiesperformed in the research paper (OPTIMIZATION OF SKELETALCONFIGURATION:STUDIES OF SCOLIOSIS CORRECTION BIOMECHANICSGEORGE T. WYNARSKY and ALBERT B. SCHULTZ*Department of MechanicalEngineering and Applied Mechanics, University of Michigan, Ann Arbor) indicateseveral facts regarding scoliosis brace treatment. Muscle forces were moreeffective than brace forces in correcting all aspects of a thoracic scoliosis. Underall circumstances examined, brace forces caused small left lumbar and left highthoracic secondary curves, and produced only modest spine de-rotations. Thestudy goes on to state that in reality the brace treatment forces had very little ifany affect on the axial rotation, the most prevalent biomechanical finding linkedto progression and ribcage deformity in children with idiopathic scoliosis.So to ask yourself the question, Should I brace my child’s scoliosis? I wouldhave to answer, NO! A better solution would be to enroll your child in a spinal
rehabilitation program the second you find out your child has a spinal curvature.There are many options available but I feel the neuromuscular spinalrehabilitation programs are superior to standard active rehabilitation exercisesprimarily because most active programs, like Schroth, prescribe spinal bracetreatment in addition to performing exercises which unfortunately is acontradiction in treatment philosophy because no matter how a scoliosis brace isapplied it is biomechanically flawed. CLEAR scoliosis treatment is gainingtraction because of its innovative core of doctors that utilize a very sophisticatedscoliosis rehabilitation approach.About the Author:Treating Scoliosis.com offers alternatives to scoliosis surgery when treatingscoliosis of the spine in adults and children. Visithttp://www.treatingscoliosis.com for more information on non-invasive scoliosistreatment plans.