Controversial Issue Session: Brace treatment in infantile scoliosis: brace treatment problems

Orthotic treatment of infantile scoliosis represents a challenge: 1. Most of them are progressive 2. Different etiologies 3. Associated diseases 4. Smaller size anatomy 5. Immature rib cage Types: 1. Braces • Do not provide immediate correction • Treatment aimed to “hold” the spine and prevent further progression • Risk of chest deformity in case of braces constricting the thorax • Literature does not support the efficacy of braces in the treatment of infantile scoliosis • Poor compliance (Parents) 2. Casts/Braces under traction • Provide correction. Sometimes scoliosis can be reversed by early treatment with serial corrective plaster jackets in children with mild curves and at an early age (under age two) • Immature rib cage often deforms before significant correction is transmitted to the spine • May provoke skin problems • They may reduce the deformity but not reverse it • Main goal: delay surgery as much as possible • Braces under traction diminish cast complications with the same efficacy in the long term