If your child has been diagnosed with scoliosis or kyphosis, a doctor may prescribe a spine brace or spine cast. These are nonsurgical treatments that can stop or slow the growth of the spine's curve. Both of these techniques are beneficial in helping stop or slow a child’s scoliosis curve from progressing. Whether your child needs a brace or cast depends on her age, how much growing she has left and the degree of the scoliosis curve.
What is spine bracing?
Spine bracing is used to help prevent curves in the spine from getting larger as your child grows. Generally, curves less than 20 degrees don’t require treatment, since most do not worsen, but children whose curve is greater than 20 degrees and who will still continue to grow are candidates for either full-time bracing (approximately 16 to 23 hours a day) or night bracing. Braces do not make curves go away but may prevent the curve in your child’s spine from worsening. There is a wide variety of braces available, and your care team will help you determine the brace that best fits your child’s condition and lifestyle.
What is spine casting?
If your child is young and still has quite a bit of growing left to do, she is most likely to be diagnosed with early onset scoliosis, and a doctor may recommend spine casting over bracing. Since very young children grow so rapidly, wearing a corrective cast can reduce or correct scoliosis curvature.
Serial casting is a special technique that does not require an incision but does require anesthesia so that an orthotist or orthopedist team can apply a casting technique called elongation, derotation and flexion (EDF). This type of cast slowly reduces the size of the curve in your child’s spine over several months. This is usually an outpatient procedure. EDF casting can result in complete correction of the curve, or at least allow for bracing of a smaller curve. This procedure is typically reserved for preadolescent children younger than 5 years old.
Casting is not 100% effective for correcting scoliosis, but it may help slow the progression of a spinal curve and delay spine surgery until your child is older. This delay is important because the chest wall and lungs need to grow and mature before there can be surgery to correct your child’s curvature.
What to expect for your child’s spine casting procedure
- Your child will be put to sleep under anesthesia, but your child’s doctor will not make any incisions. Typically, kids are able to go home the same day that the doctor applies the cast.
- There is a specially designed table that helps your child’s doctor apply the cast.
- The cast will fit under the arms to the waist or over the shoulders down to the waist. This is based on where the spinal curve is located.
- The cast cannot be removed, is typically worn for three months at a time and is sometimes alternated with spine bracing to allow for periods of rest from the cast.
Spine braces are made of firm plastic and worn around the torso—the upper part of the body. The brace may also include foam padding for comfort or correction. Velcro straps hold the brace snug as your child grows. A seamless shirt is worn underneath the brace.
Your child’s doctor will determine what type of spinal brace works best for your child, depending on your child’s age and condition. Your child may have to be fitted for a new brace or switch to a different brace as she grows. At Children’s Healthcare of Atlanta, we offer the following types of spinal braces:
You and your child may have questions as you get used to incorporating the brace into her day-to-day activities. Here are answers to some of the most asked questions the pediatric spine specialists at Children’s receive about wearing a spine brace.
Our team created a private Facebook group for scoliosis families.
We know that the scoliosis journey can be a long one—from diagnosis and bracing through surgery and recovery. This page offers forums for asking questions, sharing tips and celebrating milestones with other spine patient families.Start connecting