The Brace Treatment of Congenital Scoliosis

Congenital scoliosis is a disease characterized by its rigid and progressive curve. It is usually resistant to conservative treatment and early surgical fusion has been reommended. The indication for conservative treatment with brace is much limited but present mainly as a delaying tactic to maintain the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 17 patients (18 curves) with congenital scoliosis who were treated with brace with average follow-up of 4.3years (at least 2 years) from Jan. 1968 to Dec. 1983 and the following results were obtained. 1. The interval from the time when scoliosis was observed to the time of brace application was less than 1 year in 10 patients (58.8%). 2. The average age was 6.6 years ranging from 0.2 years to 14.1 years. The average initial curve was 40.5 degrees. 3. The average final amount of correction was 3.6 degrees (8.7%). 4. The lumbosacral curve gave the best correction. The correction effect of brace treatment was less effective in the thoracic curves. 5. The correction was more effective in the patients younger than 10 years. 6. The shorter the curve, the more correction was obtained. 7. The type of failure of formation gave much more correction than the type of failure of segmentation. 8. The brace treatment was more effective in the patients whose curves were less than 50 degrees in younger age and with the anomaly of failure of formation. Bracing would delay spine fusion until more ideal time even in severe curves or anomalies of failure of segmentation. 9. Spine fusion should be done early regardless of age for progressive curves even with brace treament.