The answer is always – No. Assuming a good in-brace correction and compliant brace wearer then the end result (curve in spine, 2 years after end of bracing) of effective bracing is always somewhere between the in-brace angle and the original out of brace angle. Therefore if a curve is overcorrected it will still drift back towards the scoliotic side once brace treatment has completed. For example Kris had a left side 26 degree curve which over-corrected in his brace to a right side 5 degrees. As long as he continues to wear his brace then his end result will likely be 5-10 degrees to the left side which would not even be considered scoliosis. (It is considered scoliosis when curve is greater than 15 degrees).

However, with other braces where the in-brace correction is poor and/or the child does not wear the brace full time then the end result will be worse than the original pre-brace angle and possibly progress to surgical threshold.

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For example, prior to bracing, Angie had a 36 degree primary lumbar with an 18 degree secondary thoracic curve. Now in her initial in-brace x-ray her secondary curve is still at 18 degrees but her primary curve is now improved to 17 degrees. Had we attempted to correct both curves we would not have been able to reduce the size of the primary curve so drastically. With further refinement we hope to get the primary lumbar curve down to 10 degrees and once stabilized at this degree we can re-assess whether we need to make adjustments for the secondary thoracic curve.

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• March 26, 2021

Doctors say that it is impossible for a brace to treat curves over 45 degrees. Annie had a 50-degree lumbar scoliosis. Normally her only option would be spinal fusion surgery. Instead she was fit with the LA 3D Brace and after only 4 weeks her curve has reduced to 13 degrees! With a little fine tuning we strongly believe that we can get her curve down to under 10 degrees. If she continues to wear her brace full time for a year she will likely be cured of her scoliosis. Thanks to the LA 3D ‘Impossible’ Brace!

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• March 12, 2021

A Study in Spine by Martin et.al. examined risk factors associated with 30-day and 90-day unplanned hospital re-admissions after pediatric spinal deformity surgery.

1. The 30-day readmission rate was 4.7 percent and the 90-day re-admission rate was 6.1 percent.

2. Infections were the most common reason for re-admissions, accounting for 38 percent of the 30-day re-admissions and 33 percent of the 90-day re-admissions. Wound-dehiscence accounted for 19 percent of the 30-day re-admissions and 17 percent of the 90-day re-admissions.

3. Pulmonary complications accounted for 12 percent of 30-day re-admissions and 13 percent of 90-day re-admissions.

4. Predictors of 30-day re-admissions include:

• Male sex

• Neuromuscular or congenital scoliosis

• Scheuermann kyphosis

• Medicaid

• Length of stay less than three days or longer than six days

• Surgery at a teaching hospital

 

A new study published in the JBJS examines 659 patients who underwent adult spinal deformity surgery and looks at how readmissions increase the total cost of spinal deformity surgery.

1. Readmission rates were 24% overall, and cost around $10 million total with an average of $15K per patient.

2. Around 8.8 percent of the admissions occurred within the first 30 days after surgery, accounting for $3.2 million, and 11.7 percent of the readmissions occurred within the first 90 days, accounting for $4.6 million.

3. Pseudarthrosis was the most expensive readmission, costing around $93K; infections and kyphosis were also expensive readmissions, costing around $75K and $67K respectively.

4. Two years after surgery, the average readmission cost was $86,081.

5. The factors associated with increased risk for readmission include: Older age; Eight or more levels fused; Longer length of stay in hospital.

Authors concluded that adult spinal deformity surgery is unique, because the most common and most expensive complications occur after one year.

 

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• February 26, 2021

In a study published in Journal of Bone & Joint Surgery February 2017 by Watanabe, K et. al., reviewed 2,600 Japanese female junior high school students who’s screening indicated possible scoliosis.

AIS was shown to be associated with classical ballet training. The odds of AIS developing increased as the child’s frequency of ballet training, number of years of experience, and duration of training in ballet increased. The Odds Ratio for AIS was also 1.5 times higher for participants whose mothers had scoliosis.

 

According to Erin Myers in Dance Magazine, “Starting ballet at a young age, increased frequency of ballet training and increased duration of ballet are associated with an increased risk for developing the abnormal curvature seen in scoliosis” (Web). As seen here, ballet has the likely-hood of increasing your chances of developing scoliosis, but it is possible to manage scoliosis without having to get surgery. To decrease your risk of scoliosis as a dancer you should, proactively monitor changes in your body, ask for scoliosis screenings, and build core strength. If diagnosed with scoliosis a LA Back Brace would effectively manage and correct your scoliosis and continue to let you do what you love.

Does Ballet Increase Your Risk of Scoliosis? – Dance Magazine

 

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• January 29, 2021

In addition to the different types/classifications, scoliosis varies by its size and treatment options differ according to the size of the curve. This is why it is important to know both the type/pattern of scoliosis AND the size of the curve in determining appropriate treatment.

 

What is the biggest curve that can be corrected with a brace? In my previous statement I specified that 55 degree curves were not braceable. In practice, it is not quite as simple as this. Some large curves are more correctable than others, hence some curves of 45 degrees are not braceable and some curves of 55 degrees are correctable. Generally speaking, if there is only one curve then 55 degrees should be the limit and if there are 2 large curves that are both structural then 45 degrees should be limit. Other factors including pattern of scoliosis, apex of the curves, age and flexibility also determine braceability. Take these images of Jahmie for instance with curves of 53 degrees thoracic and 43 degrees lumbar. Because she was very flexible, we braced her scoliosis and she had Schroth treatment and now her curves out of brace are stable at 40 degrees thoracic and 37 degrees lumbar and she has avoided having surgery.

 

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• January 22, 2021

An adolescent’s growth is not uniform with time so the time taken to outgrow a brace can vary. During the adolescent growth spurt a child can grow up to 4 inches in one year, at other times growth can be as little as 1 inch in a year. A Boston type brace that relies heavily upon symmetrical compression and a very tight fitting waist area will typically last between 6 months and 15 months. An LA brace which has pressures and voids and relies less on compression will usually last longer, from 9 months to 18 months. In addition growth is not proportional within the body and a child can change nominally in height but still outgrow their brace due to changes to hip and/or chest dimensions.

As scoliosis is often diagnosed during adolescence, for many kids who are prescribed a brace, they will have finished growing and be discharged from bracing before it gets too small. However, a number of kids will outgrow their brace before they are finished growing and need a new brace. As a general rule if you have a change in height of more than 2 inches or a change in weight of more than 10 lbs then your brace will be starting to get small. A change in height of 3-4 inches or a change in weight of 20 lbs will mean the brace is most likely now too small.

 

 

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