An international effort spanning 25 institutions including Toronto’s SickKids Hospital studied the effectiveness of bracing versus surgery in teens as a treatment in Adolescent Idiopathic Scoliosis (AIS), and found the efficacy of bracing almost entirely eliminated the need for surgery. The finding caused the trial to end early.
AIS is a curvature of the spine often requiring surgical correction. It affects 3 per cent of Canadian children and teens, and is typically diagnosed in children of 10 to 15 years. Dr. James Wright, co-author of the study and surgeon-in-chief at SickKids Hospital, was quoted in hospital press release as saying, “Bracing proved to be so effective in reducing the teens’ need for eventual surgery that the trial was halted mid-way through.”
To date, previous study designs had failed to conclusively conclude the effectiveness of bracing. This study recruited 242 high-risk adolescents with AIS aged 10 to 15 with no prior treatment. One hundred and forty-six of them were fashioned with special heat sensing braces capable of regularly logging the use of the brace. They wore the brace daily for a minimum of 18 hours; as the adolescents developed, the brace was often worn for many years. The remaining 96 adolescents only underwent observation. For 72 per cent of the treatment group, bracing successfully decreased the progression of deformities that would require surgical intervention, compared to only 48 per cent in the wait-and-see observation group which received no treatment. The benefit was even greater for longer hours of brace wear. Wright concluded: “Wearing rigid braces for 18 hours a day is not easy, but now we can advise patients and parents that wearing braces does work compared to a watch-and-wait approach.” The next stage of the study hopes to help better predict which patients are at higher risk.
