Today, bracing is rightly recognised as one of the most effective ways to treat Scoliosis without surgery. While bracing is not suitable in every case, research suggests that in the majority of patients bracing can at least halt the progression of a Scoliosis curve[1], and in many cases, a significant degree of correction to the curve is usually possible[2].
While bracing is only now starting to be viewed as a viable alternative to surgery (not least because the success rates for modern braces are not widely known) spinal bracing for Scoliosis is not a new idea – in fact, there have been Scoliosis braces for almost a long as there have been written records!
Early Bracing Techniques
Throughout history there is evidence of attempts to correct spinal conditions using bracing – for much of history, however, bracing techniques were crude and often uncomfortable. Hippocrates is thought to have been the first physician to describe the use of a wooden board to straighten a curved spine. However, this technique was not widely used until the 16th century, when Ambroise Paré, a French surgeon, developed a similar device. His device consisted of a wooden board that was wrapped around the patient’s torso and secured with leather straps. Paré believed that the device could straighten the spine by applying pressure to the curved area. Paré was clearly an intelligent man – not only was he the first to formally document the preponderance of Scoliosis in Females, his basic theory for the non-surgical treatment of the condition was essentially correct.
In the 17th century, a German physician named Lorenz Heister developed a metal brace that was designed to be worn around the torso. Heister also believed that the brace could help straighten the spine by applying constant pressure to the curved area. However, the brace was heavy, uncomfortable, and not very effective.
18th and 19th Century Bracing Techniques
In the 18th century, a French physician named Jean Baptiste Bouvier developed a new type of brace called the spinal brace. The spinal brace was made of metal and leather and was designed to fit snugly around the torso, providing support for the spine. Bouvier believed that scoliosis was caused by weak muscles and that the spinal brace could help strengthen these muscles and correct the curvature of the spine. However, the spinal brace was again, uncomfortable and not very effective.
In the 19th century, several other types of braces were developed to treat scoliosis. One of the most popular was the Taylor brace, which was developed by Dr Robert Taylor in 1864. The Taylor brace was made of metal and leather and was designed to fit snugly around the torso. Critically, the brace was adjustable, allowing the physician to apply pressure to specific areas of the spine. The Taylor brace was the first brace to be widely used in the United States and, in its adjustable nature was a key step towards the technology we have today.
Another brace that was developed in the 19th century was the Risser cast. The Risser cast was made of plaster and was designed to be worn around the torso. The cast was used to immobilize the spine and prevent further curvature. While the Risser cast was effective in preventing further curvature, it was uncomfortable and limited the patient’s mobility.
20th-Century Bracing Techniques
By the 20th century, various types of braces had already been developed – they all focused on the key goal we still have today – gently guiding the spine back into the correct alignment. What early braces lacked, however, was a material which provided enough flexibility in design to be truly effective.
One of the most significant developments of the 20th century was therefore the use of plastics in brace construction. Plastics allowed for the creation of lightweight and more comfortable braces which could be much better formed to the torso of the patient. One of the most popular of these new braces was the Boston brace, which was developed by Dr John Hall in 1972. The Boston brace was made of plastic and was designed to fit snugly around the torso, with a series of pads and straps that could be adjusted to apply pressure to specific areas of the spine. The Boston brace was more comfortable than previous braces and was effective in treating scoliosis in many patients – while the Boston brace was not often effective in reducing Scoliosis, it was the first to have a high success rate in preventing the worsening of the condition.
Bracing post-2000
Another significant development in scoliosis bracing – and one which brings us up to date – is the use of computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies. These technologies allowed for the creation of custom-made braces that are specifically designed for each individual patient. This allowed for a more precise fit and better results. Modern plastics also allow braces to be more flexible and easy to wear than ever before.
Perhaps the most important development facilitated by CAD, however, was the introduction of “active” or “over corrective” braces – such as the ScoliBrace that we offer here at the clinic. The precision offered by computer-aided design and manufacture makes it possible to produce a brace which actually opposes scoliosis – therefore actually correcting the curve over time rather than just trying to stop its progression.
Learn more about Bracing
As you can see, modern braces such as the ScoliBrace are a refinement of literally hundreds of years of thought on Scoliosis – inventors and doctors have been aware of the way to treat Scoliosis without surgery for hundreds of years, but it’s only now that we finally have the technology to make this a reality. If you’d like to learn more about scoliosis and Scoliosis bracing, why not sign up for our free information series here.
[1] ‘Effects of Bracing in Adolescents with Idiopathic Scoliosis’ [Results of the BrAIST Clinical Trial]
Stuart L. Weinstein, Lori A. Dolan, James G. Wright, and Matthew B. Dobbs, N Engl J Med 2013; 369:1512-1521 October 17, 2013DOI: 10.1056/NEJMoa1307337
‘Idiopathic scoliosis patients with curves more than 45 Cobb degrees refusing surgery can be effectively treated through bracing with curve improvements’
Negrini S, Negrini F, and Zaina F, 2011, Spine J. 2011 May;11(5):369-80. doi: 10.1016/j.spinee.2010.12.001. Epub 2011 Feb 2.
[2] ‘Brace treatment in juvenile idiopathic scoliosis: a prospective study in accordance with the SRS criteria for bracing studies – SOSORT award 2013 winner‘
Angelo G Aulisa, Vincenzo Guzzanti, Emanuele Marzetti,Marco Giordano, Francesco Falciglia and Lorenzo Aulisa, Scoliosis 2014 9:3 DOI: 10.1186/1748-7161-9-3
