Scoliosis Orthosis: An Overview Scoliosis orthosis, commonly known as a scoliosis brace, is a medical device designed to manage and correct spinal curvature in individuals with scoliosis, particularly during growth stages. It is a non-surgical intervention aimed at preventing curve progression, reducing deformity, and improving posture while allowing patients to maintain daily activities. Types of Scoliosis Orthoses Several types of braces are used based on the severity and location of the spinal curve: 1. Thoracolumbosacral Orthosis (TLSO): The most common type, such as the Boston brace or Wilmington brace, fits around the torso and applies corrective pressure to the thoracic and lumbar spine. It is typically worn under clothing for 18–23 hours daily. 2. Milwaukee Brace: A cervical-thoracic-lumbar-sacral orthosis (CTLSO) with a neck ring, used for high thoracic curves. Though less common today, it remains effective for specific cases. 3. Charleston Bending Brace: Worn only at night, this brace applies overcorrective force to the spine in a side-bending position. 4. SpineCor Brace: A dynamic, flexible brace that allows movement while providing corrective tension through straps. Mechanism of Action Scoliosis braces work through biomechanical principles: - Three-Point Pressure System: Strategic pads apply pressure to the convex side of the curve while allowing room for the concave side to expand, guiding spinal alignment. - Tissue Remodeling: Consistent wear influences bone and soft tissue growth, particularly in adolescents with remaining skeletal growth potential (Risser sign 0–2). - Postural Support: The brace reinforces proper posture, reducing asymmetric loading on the spine. Indications and Effectiveness Bracing is primarily recommended for: - Adolescents with idiopathic scoliosis and curves between 20°–40° (Cobb angle). - Patients with significant growth remaining (pre-menarchal or Risser stage ≤2). - Progressive curves observed during monitoring. Studies show bracing can reduce the need for surgery by up to 70% when compliance exceeds 12–16 hours/day. Success depends on curve flexibility, skeletal maturity, and patient adherence. Challenges and Considerations - Compliance: Long wear time and discomfort may lead to poor adherence. - Physical Limitations: Some braces restrict movement, affecting sports or daily tasks. - Psychological Impact: Body image concerns may arise, requiring emotional support. Conclusion Scoliosis orthosis remains a cornerstone of conservative management for moderate spinal curvature. While not curative, it effectively halts progression in many cases, delaying or avoiding surgical intervention. Advances in materials and design continue to improve comfort and usability, enhancing patient outcomes. Regular monitoring by orthopedic specialists ensures optimal brace fitting and treatment efficacy. (Word count: 500)