Recently, study results were released from Texas Scottish Rite Hospital for Children regarding the Boston Brace for scoliosis and its efficacy. Adolescent curves of 25º to 45º at the time the study began were followed over the course of a year. Patients wore braces equipped with heat sensors to measure hours of wear.
The results: patients wearing the brace more than 12 hours/day experienced an 18% failure rate, while patients wearing the brace less than 7 hours/day had a 69% failure rate. Initially, participants were told to wear the brace 16 hours/day and 23 hours/day. It is unclear why results were not reported in those same terms. Based on my experience with adolescents, I suspect it is due to difficulty achieving full compliance based on an aggressive wear schedule.
Failure in the study was defined by two criteria: One, it was determined that the subject required surgery. The recommendation for surgery should depend on a number of variables, but it is generally understood that scoliosis surgery is often recommended once curvatures measure 45º to 50º+. (I strongly disagree with this Cobb angle measurement as a starting point for surgical intervention, but that discussion is for another day). The second criteria for failure was a curve variation of 6º or more as measured when the patient was out of the brace versus in the brace. Study results also stated the younger the patient, the more important brace wear. Those findings make sense, of course, and are aligned with the purpose of spinal bracing in the first place: to halt curve progression during growth.
Currently, I have patients wearing the Boston Brace who are involved in a similar study. That study also uses heat sensors to measure brace wearing habits. It will be interesting to see the outcomes from that study versus the Texas Scottish Rite results. I am also curious to find out how Schroth patients compare to the general population in that study. It is my hypothesis that Schroth patients wearing the Boston Brace will do very well compared to the other participants. Stay tuned.
