Brace treatment for scoliosis
Scoliosis is when the spine is crooked. The spine in patients with scoliosis appears in an S-shape when standing behind the patient. In addition, there is also an unnatural rotation of the spine. Sometimes, in addition to scoliosis, there is also increased kyphosis or lordosis, i.e. a strong forward (kyphosis) or backward leaning spine (lordosis).
One measure used to treat severe scoliosis is wearing a corset.
Read more about the topic: Back orthoses
The use of a corset only makes sense if the spine is still growing and the direction of growth can still be influenced from outside. So this applies to children and adolescents who are still in the growth phase.
The growth must also last at least 2 years if you decide to use a corset.
It is also important that a corset is only suitable for certain scoliosis. Corsets are used for curvatures between 20 and 35 degrees of the spine. If there is a greater curvature, this measure does not help due to the severity of the twist. In this case, an operative approach must usually be chosen.
There are numerous types of spinal corrective corsets. The so-called Cheneau corset. It starts with all three malformations in scoliosis and has a deforming effect through a built-up tension on the spine.
The S-shape is slowly brought into a straight position when worn regularly. Furthermore, the corset also reduces the twisted spine, i.e. it unwinds the spine. In addition to straightening, the corset acts like a splint and ensures that further growth is straightened out.
Corsets in general are placed on the person's back. Similar to a rail, close contact with the fuselage must be guaranteed in order to achieve a corresponding effect. For further stabilization, the splint is placed around the patient's abdomen from behind by means of belt-like struts and fastened in a so-called support strut at the front. It is important to ensure that the entire corset is tight and stable. If the trunk can no longer be moved independently because the corset prevents the person concerned, then the corset is correctly put on.
For children in particular, this restriction represents a massive cut in daily life, especially since children often do not yet have the insight into such treatment.
Since scoliosis does not cause any symptoms in the early phase, it is also very difficult for children to understand the need for a corset for this reason. It is extremely important to start treatment early, as severely crooked spinal columns can often no longer be treated with this method. The same applies to spinal columns that are no longer growing.
Find out basic information about the possible measures for scoliosis:
- Therapy of scoliosis
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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How many degrees do you need a corset?
Depending on the severity and orientation of the scoliosis, a corset is recommended or not recommended.
A lateral deviation of up to 10 ° is usually still considered physiological and does not require any treatment. Only when the so-called Cobb angle deviates by more than 10 ° is officially referred to as scoliosis.
From an angle of around 20 ° you should urgently intervene. Here, the treatment usually takes place through physiotherapy.
This is to prevent the progression of a disease as much as possible.
If the Cobb angle is more than 25 °, fitting and wearing a corset is absolutely recommended.
Surgical intervention should normally be performed from an angle of 50 °.
Also read the article on this topic:
- Surgery for scoliosis - what are the options?
Performing the corset treatment
If the indication for a corset treatment has been made, the patient is measured by a complex procedure in order to determine the correct sizes for the production of the corset. After the corset has been completed, it is adapted to the patient. It is important that the corset should only be worn briefly and then the wearing time must be increased slowly. Similar to wearing new shoes, a corset should only be worn for a short time for the first few days in order to avoid pressure points on the body and to increase patient compliance.
How long must a corset be worn?
After making a corset and starting to wear it, you should first get used to wearing a corset. In order not to overwhelm the body from the outset, the wearing time should be increased over time.
While in the past a 23-hour wearing time per day was postulated, today the view is somewhat more liberal.
Research has shown that a 23-hour wearing time does not improve the end result that is available with a wearing time of around 17 hours.
This is a long time, but the patient will be very happy to be able to take off the corset 7 hours a day.
Most of the time, the patients decide not to wear the corset during work or school, while most of them are even willing to wear the corset while sleeping in order to get the necessary hours.
In order to improve the result with a wearing time of 17 hours, regular, additional physiotherapy treatment is very useful and important.
A corset should be worn until the patient has completed the growth phase.
Depending on when a patient starts wearing it, he or she will have to wear the corset either longer or shorter. However, from the age of 16 or 17, the patient would be advised to omit the corset, because the spine becomes increasingly unformable at this age.
A corset is adapted to the patient so that it can always have a supportive effect where the spine shows instabilities.
In order to enable the most exact adjustment possible, an X-ray image is usually recorded in combination with a 3D body scan. The corset can then be made to measure using plaster casts.
The adjustment of a corset should definitely be done by an experienced orthopedic technician.
Most often, from a Cobb angle of 20 degrees, the so-called Chêneau corset is prescribed:
It has an asymmetrical structure and is intended to apply pressure to certain areas. As a result, the body moves into the open spaces of the corset, especially when inhaling. These free spaces are precisely adjusted so that the spine develops in the intended direction.