Effect of Bracing and Other Conservative Interventions in the Treatment of Idiopathic Scoliosis in Adolescents: A Systematic Review of Clinical Trials

Abstract

Background and Purpose. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in adolescents by systematically reviewing the literature. Methods. The literature was searched in the PubMed, CINAHL, Cochrane, and PEDro databases. Studies were selected if the design was a randomized clinical trial or a controlled clinical trial, if all patients had an idiopathic scoliosis, if all patients were less than 18 years of age during the intervention, and if the type of intervention was a conservative one. Two reviewers independently assessed the methodological qualityusing the Delphi list and performed data extraction. Analysis was based on the levels of evidence. Results. Thirteen studies met the final inclusion criteria, showing a wide range of interventions such as bracing, electrical surface stimulation, and exercises. Discussion and Conclusion. The authors conclude that the effectiveness of bracing and exercises is not yet established, but might be promising. They found no evidence of the effectiveness of electrical stimulation.

Braces for Idiopathic Scoliosis in Adolescents

“…Treatment options for the prevention of AIS progression include exercises, bracing, and surgery [1,[19][20][21][22][23][24][25][26][27][28][29]. Bracing can be defined as the application of external corrective forces to the trunk.…”

Comparison of the biomechanical 3D efficiency of different brace designs for the treatment of scoliosis using a finite element model

“…For moderate deformities, bracing is the most common treatment. However, its efficiency in preventing the progression of scoliotic deformities is still controversial [14,17,19,20,29]. Many questions remain about what could be the best brace design.…”

A randomised controlled trial on the effectiveness of bracing patients with idiopathic scoliosis: failure to include patients and lessons to be learnt

“…Early treatment by bracing is thought to prevent further progression of the curvature and thereby to prevent the need for surgery [6,7]. The effectiveness of bracing, however, has not been sufficiently established due to a lack of randomized controlled trials (RCT) [15,24]. The studies on bracing that have been done were mostly retrospective studies, or studies without a control group.…”

“…The authors concluded that bracing was effective. However, this study was non-randomized, non-blinded and with baseline differences between the groups [15,24]. Several authors have stated that a RCT, in which the control group (initially) is not offered brace treatment, should be conducted [8,9,14].…”