Scoliosis brace treatment has been around for well over 100 years in many different forms. We have hard braces, soft braces, night time only braces, and braces that are like a full body cast. Among the many issues with bracing, I discuss my top four issues with bracing:
Child Compliancy: Most of the children that get fitted for brace won't wear them. Braces are uncomfortable and socially-emotionally taxing. Consider the heat generated by a child in a hard brace in the summer months. Then, expect a child to wear a brace for 20-hours per day. It's not fun during the day and likely worse at night. Consider sleeping with a tightly fitted soft or hard brace. Can you feel how tightly it hugs around your child? Can you imagine the limited range of motion he/she has as he/she tries to sleep? It's no wonder children do not comply with wearing one. Aside from the physical considerations there are also psychological/social factors that influence a kids behavior. Wearing a brace to school is emotionally taxing for a child. Unfortunately, social acceptance and group think is the stage of social development most children are at during the 'brace-wearing' years. Naturally, they will worry how they look and what their peers will think of them in a brace. Sports at school are impossible while wearing a brace. How would a child go away to a sleep away camp or spend the night at a friends house. The last thing they want is to be 'different' or found out! We would be remiss to disregard the psychological/social factors of kids wearing a brace. The reality is that most kids will wear the brace to school, take off the brace while in school, and put the brace back on at dismissal. But, let's say for argument's sake that kids wore their braces as prescribed. I argue, braces are still ineffective. See my three reasons below.
Effectiveness: The doctor will recommend a brace if the curve goes above 25 degrees. Once you get the brace you see all it does is squeeze your ribs to force the spine straight. It is like squeezing a square peg into a round hole. That does not work, not only does it not work but it makes it worse. What the brace accomplishes is making the spine stiffer. Just as with any joint, if there is a lack of motion that area will become stiff. The other thing it accomplishes is muscle atrophy. "Use it or loose it" is an expression we are all too familiar with. If you don't use your muscles they become weaker and weaker over time. Given this fact, answer this... How will your body/muscles hold your 'new' posture post brace? Where's the muscle? Answer: It won't hold! Once the brace wearing period is over there is not enough strength in the muscle to support the spine.
Rib compression: In order for the brace to work it needs to press on the ribs to move the spine. The brace cannot press directly on the spine. The brace needs to go through the ribs to get to the spine. When a 3D x-ray was taken on a braced child we observed that the rib deformity became much worse. Consider this: We know scoliosis starts with rotation and that rotation drives the curve. We also know that rib hump deformity happens due to rotation of the vertebra. Answer this: Why then, I ask, is the use of a scoliosis brace allowed?
Results: There are various articles that claim the percentages of the effectiveness of the brace; percentages vary anywhere from 10% to 70%. I argue that it is more likely the case that effective percentages hover around the 20% mark. That explains the high number of post-brace wearing candidates consulting orthopedist for surgery. The other fact that most people don't know is that about 20% of people with scoliosis won't get worse anyway. This begs the question: Are the people for whom the brace was (supposedly) "effective" truly the result of the brace? Could it have been that it was never in their genetic DNA to have their scoliosis worsen? Consider a study by Weinstein and Dorlan where they conclude that wearing a scoliosis brace vs not wear a brace has no significant impact on scoliosis.
It is important to do your research and raise these questions. Be an advocate for yourself and make informed decisions. After all it is your life and you are living with the consequences of your decisions.
No comments:
Post a Comment