REVIEW ARTICLE


Brace Prescription for Adult Scoliosis - Literature Review



Shu Yan Ng1, Tai Hong Andrew Lung1, *, Lok Yan Joanne Cheng1, Yin Ling Elaine Ng2
1 Hong Kong Chiropractic College Foundation: 11&12/F China Hong Kong Tower, 8-12 Hennessy Road, Wan Chai, Hong Kong SAR
2 Pedorthic Technology Limited, Wan Chai, Hong Kong SAR


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Creative Commons License
© 2022 Ng et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Hong Kong Chiropractic College Foundation, 11&12/F China Hong Kong Tower, 8-12 Hennessy Road, Wan Chai, Hong Kong SAR; Tel: +852 39983208; Fax: +852 39983222; E-mail: lthandy@outlook.com


Abstract

Purpose:

The 2021 SOSORT guidelines stipulated that braces be prescribed for adult scoliosis with chronic pain and progressive curve. Yet, there have been no objective protocols relating to the prescription of the brace. Therefore, this review investigates if there are any objective criteria or generally agreed on protocols for brace prescription in adult scoliosis patients.

Methods:

Relevant papers were searched in PUBMED. Only articles that are in English and cover the clinical aspect of adult scoliosis bracing are included.

Results:

A total of twelve papers were identified. They include different adult scoliosis braces, ranging from elastic belts to rigid braces. The treatment protocol varied tremendously. No objective criteria were found concerning the prescription of a brace, daily wearing time, duration of the intervention, and weaning protocol. The brace treatment was primarily employed to manage low back pain.

Conclusion:

Our search showed no objective criteria and clear indications for bracing and no consensus concerning the prescription of braces, daily wearing time, and duration of the intervention for patients with adult scoliosis.

The authors proposed prescription of a brace be based on more objective radiological criteria and severity of low back pain. Brace prescription should depend on the flexibility of the curve and can range from accommodative to rigid braces of corrective design. “Corrective” brace has to be worn at least 14 hours daily for six months or until the low back pain subsides to the extent that permits daily activities with minimal discomfort. “Accommodative” brace can be worn when required.

Keywords: Adult idiopathic scoliosis, Degenerative lumbar scoliosis, Brace, Orthotic, Spine, Scoliosis.