In many cases, Adolescent Scoliosis treatment begins with wearing a TLSO brace. Scoliosis curves under 25° watched for progression. Curves between 25°-30° with a 5° marked increase are braced. Curves between 30°-40° are braced. Surgery is considered for curves over 40°.
It is uncommon that the brace will permanently correct the curves. When bracing is discontinued the curves generally return to their pre-braced Cobb angle quickly after being discontinued. Moreover, for unknown reasons, certain curves progress despite brace treatments.
When the brace is worn as prescribed, which can be up to 23 hours per day, it can alter the progression of the curvature, and prevent surgery. For the brace to be effective, it should be worn until impending skeletal maturity and then weaned slowly. Proper application of the brace is essential to the effectiveness in managing the curvature.
Step one: Patient should be on their back with hips slightly flexed. Locate the patient’s waist, and spread brace over body.
Step Two: Raise the patient’s arm above their head. Log roll patient towards raised arm and onto their side. Be sure hips and upper body move together without twisting.
Step Three: Place back section of the brace behind the patient. The waist roll of the brace should align with the patient’s waist.
Step Four: Pull the straps under the brace and pull through the loops.
Step Five: Roll the patient back and secure the straps.
Step Six: Make sure the straps are adjusted evenly.
These photos were provided courtesy of Lerman and Son Bracing in Los Angeles, CA.