Scoliosis and Hyper-Kyphosis Bracing
Scoliosis and Hyper-Kyphosis Bracing
An evidence based, non-surgical approach to scoliosis and hyperkyphosis following international guidelines.
Scoliosis Bracing
Bracing protocols for adolescent idiopathic scoliosis (AIS) aim to prevent curve progression in skeletally immature patients. The most common protocol involves full-time bracing, typically for 20-24 hours a day, particularly for curves between 20 and 50 degrees. Nighttime bracing, worn for 8-12 hours, is another option, but evidence for its efficacy is limited. Compliance with the bracing protocol is crucial for successful treatment.
When to Begin Bracing:
Bracing is generally recommended for AIS curves between 20 and 50 degrees in patients who are still growing.
Types of Braces:
Spine, Limb & Scoliosis is a ScoliCare Affiliate Clinic. Dr Hayden is an experienced scoliosis clinician and a certified ScoliBrace provider. He is also a certified Level 2 ScoliBalance provider (Physiotherapeutic Scoliosis Specific Rehabilitation).
ScoliBrace is a 3D custom designed over-corrective brace, made for the patient with computer aided design and manufacture (CAD/CAM).
The over-corrective approach guides the body and spine into a posture that is the opposite of how the scoliosis is shaped. Curve reduction is often achieved, improving the overall appearance of the body, and improving function and pain are also treatment goals.
ScoliBrace is patient friendly, opening and closing at the front making it easy to wear and remove without assistance. There are also a variety of unique colors and patterns available for patients to personalise the look of their brace.
Compliance:
Consistent adherence to the prescribed wearing schedule is essential for brace treatment to be effective.
Brace Weaning:
There is no universally agreed-upon weaning protocol, but bracing is generally gradually discontinued once skeletal maturity is achieved, often after several years of treatment.
Physiotherapeutic Scoliosis Specific Rehabilitation (PSSE):
Bracing is usually combined with physiotherapeutic scoliosis-specific exercises to improve posture, manage pain, and help stabilise the spine.
Factors Influencing Bracing Decisions:
The severity of the curve, the patient’s skeletal maturity, and the overall treatment goals are all considered when determining the need for bracing and the duration of treatment.
Research and Studies:
The National Institutes of Health (NIH) Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) study found that bracing significantly reduced the progression of curves to the surgical threshold.
The NIH Bracing Adolescent Idiopathic Scoliosis (BASIS) study is a randomised controlled trial comparing full-time and nighttime bracing in AIS patients.
Important Considerations:
Individualised Treatment:
Bracing protocols are not one-size-fits-all and should be tailored to the individual patient’s needs and characteristics.
Regular Monitoring:
Patients undergoing brace treatment are monitored regularly to assess curve progression and adjust the treatment plan as needed.
Hyper-Kyphosis Bracing
- Hyper-Kyphosis > 80 degrees which are stiff and progressing may need surgical consideration
- Hyper-Kyphosis > 60 degrees at skeletal maturity tend to progress and cause pain
- Hyper-Kyphosis > 50 degrees in growing children require bracing and Physiotherapeutic Scoliosis and Hyper-kyphosis Specific Exercise (PSSE)
- Hyper-Kyphosis 50-60 degrees at adulthood require Physiotherapeutic Scoliosis and Hyper-kyphosis Specific Exercise (PSSE)
- Hyper-Kyphosis 60-80 degrees at adulthood require bracing and Physiotherapeutic Scoliosis and Hyper-kyphosis Specific Exercise (PSSE) depending on flexibility.
Benefits of Bracing for Hyper-kyphosis:
Braces can help to correct the kyphotic curve and prevent further progression, especially in growing individuals.
Improved Posture:
Bracing can help to improve overall posture and reduce the appearance of hyper-kyphosis.
Pain Reduction:
In some cases, bracing can help to alleviate pain associated with hyper-kyphosis.
Improved Functionality:
Braces can improve mobility, back extensor strength, and respiratory function.
Psychological Benefits:
Bracing can improve a person’s self-esteem and body image, which can be affected by hyper-kyphosis.
Important Considerations:
Early Bracing:
The earlier bracing is started, the better the outcomes are likely to be, particularly for children and adolescents.
Compliance:
Brace wear is typically required for 18-23 hours per day to be effective, and compliance is crucial for success.
Individualised Approach:
Brace type, duration, and wearing schedule should be determined by a healthcare professional based on individual needs and the severity of the hyper-kyphosis.
Physiotherapeutic Hyper-Kyphosis Specific Exercise (PSSE):
Bracing is often combined with PSSE to strengthen back muscles and improve posture.
Types of Hyper-Kyphosis Braces:
Spine, Limb & Scoliosis is a ScoliCare Affiliate Clinic. Dr Hayden is an experienced scoliosis and hyper-kyphosis clinician and a certified ScoliBrace and KyphoBrace provider. He is also a certified Level 2 ScoliBalance provider (Physiotherapeutic Scoliosis and Hyper-kyphosis Specific Exercise).
ScoliBrace and KyphoBrace are 3D custom designed over-corrective braces, made for the patient with computer aided design and manufacture (CAD/CAM).
The over-corrective approach guides the body and spine into a posture that is the opposite of how the scoliosis or hyper-kyphosis is shaped. Curve reduction is often achieved, improving the overall appearance of the body, and improving function and pain are also treatment goals.
ScoliBrace and KyphoBrace are patient friendly, opening and closing at the front making it easy to wear and remove without assistance. There are also a variety of unique colours and patterns available for patients to personalise the look of their brace.
Conditions Treated
✔ Idiopathic & Degenerative Scoliosis
✔ Scheuermann’s Hyper-Kyphosis
✔ Postural Kyphosis & Spinal Imbalances
✔ Neuromuscular Scoliosis (in select cases)
✔ Adolescent & Adult Spinal Deformities
Benefits of This Approach
✔ Non-invasive, research-supported treatment alternative
✔ Reduces pain, helps prevent curve progression, and enhances posture
✔ Improves respiratory function, muscle control, and mobility
✔ Tailored programs for children, adolescents, and adults
This comprehensive, non-surgical approach empowers individuals with scoliosis and hyper-kyphosis to actively manage their condition, reducing the need for more invasive interventions while enhancing spinal health and overall quality of life.
