What to Expect When You Have Adolescent Idiopathic Scoliosis (AIS)
Finding out you have to wear a scoliosis brace can be overwhelming. Maybe you have been watching your curve for a while now, or maybe you just discovered it. Either way, this blog is to help answer some questions you might have about what to expect through out the process of getting a brace.
What is Adolescent Idiopathic Scoliosis?
Adolescent Idiopathic Scoliosis is the most common type of scoliosis, it breaks down into 3 parts. Adolescent: this refers to the age of the patient, adolescent means the patient is 10 to 18 years old. Idiopathic: this means that there is no identifiable cause of the scoliosis. Scoliosis: This refers to the curvature of your spine, which often has a curve in the shape of an C or an S.
Why do I have to wear a brace now? Last year they said my curve was fine!
If you have been monitoring your curve with your doctor for a while now, and at your last visit the decision was made to start bracing, it is likely that your curve has progressed. Your curve has probably done one of two things. A: Your curve has progressed to be 25 degrees or larger. 25 degrees is the magic number where we start to think that orthotic intervention (bracing) will result in the best long-term outcome. B: Your curve has progressed significantly in a short amount of time. Your doctor will determine if the change in your curve between visits justifies orthotic intervention. A large jump in degrees over a short period of time can indicate your curve is aggressive, and your doctor may decide that we want to get ahead of it to stop it from progressing even more.
What makes my curve get worse?
Growth! Your curve is likely to progress during a growth spurt. If your curve progresses, it doesn’t mean that you did anything wrong!
Why do I have to wear a brace?
The idea behind bracing is to stop the progression of the curve. If your curve gets to 50 degrees, that’s the magic number where surgical intervention may be the best treatment option. Wearing a brace can stop your curve from ever reaching that number, and thus prevent surgery from happening! Goals of a scoliosis brace vary person to person, but some common goals are to stop progression of the curve, improve postural balance (is your head directly over your pelvis when standing?) and achieve 50% curve correction in the brace (this varies depending on rigidity and type of curve).
How does a brace work?
A scoliosis orthosis (brace) works using 3 point forces along with de-rotational forces to straighten your spine. By holding your spine in a corrected position, it can guide the growth of your spine in the right direction, instead of the way it was heading without your brace.
How long do I have to wear it?
The number of hours per day you wear your brace will depend on your doctor’s preference and the style of brace that best fits your curve, but generally you’ll wear your brace 18 hours a day. This may seem like a lot but it’s important to think of the 6 hours a day you have OUT of your brace and use them wisely. You will wear your brace until you hit skeletal maturity, or you stop growing. Your doctor will monitor this with regular x-rays.
What will my brace look like?
You, your doctor, and your orthotist will decide on a brace design that suit you and your curve. The brace is made from plastic and foam and there are a number of fun patterns to choose from! You can even add stickers to it if you want.
How do I get fitted for a brace?
After getting a prescription from your doctor, you’ll see your orthotist for an initial evaluation. They’ll chat about your history and then take a combination of measurements and or scans to make sure your brace is fit to you! After a few weeks you’ll return for a fitting appointment, your orthotist will keep making adjustments until your brace is fitting well.
Finding out you have to wear a scoliosis brace can be overwhelming, but I promise it gets easier! We are here to help you through and answer any questions you might have. It is important to remember that bracing for scoliosis works! The brace is not forever, but surgery is! In a research study referenced below, 75% of patient’s curves who wore a brace did not progress to the surgical threshold of 50 degrees, where only 42% of patients curves who did not wear a brace were not surgical candidates.
Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing adolescents with idiopathic scoliosis. N Engl J Med. 2013; 369:1512-1521. http://www.nejm.org/doi/pdf/10.1056/NEJMoa1307337.