“Adult Scoliosis Bracing represents an acceptable alternative to surgery for patients who cannot or do not want to be operated on”
Effects of Bracing in Adult With Scoliosis: A
Retrospective Study
Cle´mence Palazzo, MD, PhD,a,b Jean-Paul Montigny, MD,c Fre´de´ric Barbot, MD,d
Bernard Bussel, MD, PhD,a Isabelle Vaugier, MD,d Didier Fort, MD,e Isabelle Courtois, MD,f
Catherine Marty-Poumarat, MDa
From the a
Department of Spinal Rehabilitation, Raymond Poincare´ Hospital, Garches; b
INSERM U1153, Faculty of Medicine Paris-Descartes,
Department of Physical Medicine and Rehabilitation, Cochin Hospital, Paris; c
Department of Physical Medicine and Rehabilitation, Foch
Hospital, Suresnes; d
INSERM CIC 1429, Raymond Poincare´ Hospital, Garches; e
Institute of Physical Medicine and Rehabilitation, Nancy; and
f
Department of Spinal Rehabilitation, Saint Etienne Hospital, Saint-Etienne, France.
Abstract
Objective: To assess the effectiveness of bracing in adult with scoliosis.
Design: Retrospective cohort study.
Setting: Outpatients followed in 2 tertiary care hospitals.
Participants: Adults (NZ38) with nonoperated progressive idiopathic or degenerative scoliosis treated by custom-molded lumbar-sacral
orthoses, with a minimum follow-up time of 10 years before bracing and 5 years after bracing. Progression was defined as a variation in
Cobb angle 10 between the first and the last radiograph before bracing. The brace was prescribed to be worn for a minimum of 6h/d.
Interventions: Not applicable.
Main Outcome Measure: Rate of progression of the Cobb angle before and after bracing measured on upright 3-ft full-spine radiographs.
Results: At the moment of bracing, the mean age was 61.38.2 years, and the mean Cobb angle was 49.617.7. The mean follow-up time was
22.011.1 years before bracing and 8.73.3 years after bracing. For both types of scoliosis, the rate of progression decreased from 1.28.79/y
before to .21.43/y after bracing (P<.0001). For degenerative and idiopathic scoliosis, it dropped from 1.47.83/y before to .24.43/y after
bracing (P<.0001) and .70.06/y before to .24.43/y after bracing (PZ.03), respectively.
Conclusions: For the first time, to our knowledge, this study suggests that underarm bracing may be effective in slowing down the rate of
progression in adult scoliosis. Further prospective studies are needed to confirm these results.
Archives of Physical Medicine and Rehabilitation 2017;98:187-90
ª 2016 by the American Congress of Rehabilitation Medicine
Conclusions
This study suggests that custom-molded lumbar-sacral orthoses
are effective in slowing down the progression of adult scoliosis.
Considering its limited side effects, bracing should be proposed as
the first-line treatment in association with physiotherapy. It represents an acceptable alternative to surgery for patients who
cannot or do not want to be operated on. These results must be
confirmed by prospective trials.
