Scolibrace Vs. Hospital brace – which is better?

At the UK Scoliosis clinic, our primary focus is to allow as many patients as possible to benefit from the chance to beat scoliosis through non-surgical methods as possible. Research as well as our own experience demonstrates that scoliosis bracing is the best way to achieve this – and for this reason were broadly supportive of any kind of scoliosis bracing technology available. This being said, we’ve said before that all braces are not created equal – some are just more effective than others.


Why ScoliBrace?

Our preferred brace and the one we offer at the clinic is the ScoliBrace. ScoliBrace is a totally customised brace, designed to achieve maximum curve correction as quickly as possible – but as well as being a highly effective corrective device, ScoliBrace is (in our opinion) the most patient-friendly brace on the market. It’s a low profile brace, and is practically invisible under clothing – unlike traditional braces, ScoliBrace opens and closes at the front making it easy to wear and remove without assistance. ScoliBrace is even flexible enough to allow the wearer to participate in normal physical activity while wearing the brace. What’s more, you can customise your ScoliBrace! – There are a variety of colours and patterns available for patients to personalise the look of their brace – overall, we think these factors make it the best choice for patients today.


How effective is ScoliBrace?

ScoliBrace stacks up favourably vs. the traditional thoracolumbosacral orthosis (TLSO) braces available through hospitals and some other clinics – and one recent study shows just how great the difference can be. The recently published study from Dr Jeb McAviney of ScoliCare (Sydney, Australia) concerned a male patient who was referred to the ScoliCare clinic at the age of seven with a previous diagnosis of juvenile idiopathic scoliosis. The patient had previously been fitted with a traditional 3-point pressure thoraco-lumbo-sacral orthosis (TLSO) that had been designed by a hospital orthotist[1].

The patient reported that he regularly participated in rugby, soccer and swimming. Aside from the spinal deformity, the patient was otherwise healthy. On examination a right thoracic curve and a left lumbar curve were noted.

The patient provided x-rays that had been taken at the time of the initial diagnosis as well as x-rays taken soon after the brace fitting (Figure 1). The initial pre-brace x-rays revealed that the patient’s primary thoracic curve was 32° Cobb and the secondary lumbar curve was 27° Cobb.

An examination of the in-brace x-rays for the hospital made TLSO demonstrated that an adequate in-brace correction had not been achieved with only an 11° reduction in the thoracic curve and no measurable change in the magnitude of the lumbar curve (Figure 1).

Dr McAviney proceeded to design and fit a customised ScoliBrace for the patient – In-brace x-rays taken soon after the fitting of the new ScoliBrace demonstrated a significantly better in-brace correction compared to the previous brace.

The patient’s primary thoracic curve had been reduced to down to 13° Cobb, which represented a 59% correction of the initial curve and a 25% improvement on the correction obtained with the hospital-made TLSO.

The lumbar scoliosis was almost completely reduced (3° Cobb) in the new orthosis. The hospital-made TLSO had not achieved any correction in this region of the spine (Figure 2).


This is just one case which demonstrates that all braces are not equal – the right brace at the right time is needed for real improvement.

Is ScoliBrace right for me?

If you’ve been diagnosed with scoliosis you will have numerous treatment options – bracing is one of these, while exercise-based therapy is the other major one. For very small curves exercise-based approaches may be preferable, but in most cases, we recommend you consider bracing.

Since Scoliosis presents in a unique way in every patient, ScoliBraces are custom designed to fit your exact needs – Fundamentally, Scoliosis is a 3 Dimensional condition, so we believe effective treatments need to be 3 dimensional too. Your brace will be designed using 3D full-body laser scanning technology, x-rays and posture photographs.

Each brace is then produced for the individual with Computer Aided design (CAD) and then created with Computer Aided Manufacture (CAM).

ScoliBrace is typically recommended for the treatment of Cobb angles from 25-50 degrees. It is suitable for wearers of all ages and comes custom-designed for your specific requirements. For curves less than 25 degrees, bracing may still be the preferred choice, as it’s a faster treatment than exercise – it’s also much easier for smaller children to manage (just put the brace on, rather than performing complex exercises). For curves greater than 50 degrees, bracing may still be possible – book an appointment with a scoliosis professional today!

Don’t forget that the UK Scoliosis clinic now offers online consultations too – so if you have questions, book an appointment today!


Images in this article are courtesy and copyright ScoliCare Australia.



[1] Dr Jeb McAviney, Superior In-brace Correction Achieved with a ScoliBrace Compared with a Standard TLSO in a Juvenile Scoliosis Patient (ScoliCare, 2020)



Is bracing an effective treatment for Adolescent Idiopathic Scoliosis? BRAIST study says yes!

Adolescent idiopathic scoliosis is characterized by a lateral curvature of the spine, with a Cobb angle of more than 10 degrees and vertebral rotation. Scoliosis develops in approximately 3% of children younger than 16 years of age, although rates of Scoliosis are typically much higher amongst at-risk groups such as dancers and gymnasts.  Curves larger than 50 degrees are typically associated with a high risk of continued worsening throughout adulthood and thus are most likely to be recommended for a surgical procedure.[1]


Our Scolibrace is comfortable, effective and low-profile

Treatment with rigid bracing (thoracolumbosacral orthosis or TLSO) is the most common non-surgical treatment for the prevention of curve progression. There are many different brace designs, but with all of them, the objective is to restore the normal contours and alignment of the spine while preventing scoliosis progression. The most effective designs (like our Scolibrace system) seek to deliver superior outcomes by providing active correction of the curve.

But is bracing effective?  – Today you’ll still find some practitioners who are unclear on the outcomes you can expect from bracing. This is because although historical studies of bracing in adolescent idiopathic scoliosis had suggested that bracing decreases the risk of curve progression.[2] in some of these earlier studies results were inconsistent, the studies were observational, and only one prospective study enrolled both patients who underwent bracing and those who did not.[3] Thus, for some time the effect of bracing on curve progression and rate of surgery was unclear. This all changed thanks to the Bracing in Adolescent Idiopathic Scoliosis Trial (BRAIST), which finally determined the effectiveness of bracing – as compared with observation – in preventing progression of the curve to 50 degrees or more.

The BRAIST study was a large-scale endeavour, conducted in 25 institutions across the United States and Canada. Enrolment began in March 2007.  The target population for this study was patients with high-risk adolescent idiopathic scoliosis who met current indications for brace treatment – specifically this meant an age of 10 to 15 years, skeletal immaturity and a Cobb angle for the largest curve of 20 to 40 degrees.[4] To be eligible, patients could not have received previous treatment for adolescent idiopathic scoliosis.



During the BRAIST study, patients in the observation group received no specific treatment, whereas patients in the bracing group received a rigid brace, prescribed to be worn for a minimum of 18 hours per day. Participating centres prescribed the type of brace used in their normal clinical practice. Wear time was determined by means of a temperature logger embedded in the brace and programmed to log the date, time, and temperature every 15 minutes. A temperature of 28.0°C (82.4°F) or higher[5] indicated that the brace was being worn.

Both patients and clinicians were aware of the assigned treatment. However, all radiographic (x-ray) evaluations and outcome determinations which were made at the conclusion of the study were performed by experts without knowledge of the treatment protocol, to avoid bias.



During the study, a total of 146 patients (60%) received a brace, and 96 (40%) underwent observation only. The two study groups were generally similar with respect to baseline characteristics, except that the patients in the bracing group were slightly taller on average than those in the observation group (156.5 cm vs. 153.6 cm).

The results shown at the end of the study were conclusive – the rate of treatment success was 72% in the bracing group and 48% in the observation group. By contrast, the rate of treatment failure was only 25% with bracing, but 58% with observation alone.[6]

Therefore, given a large sample set and a study carried out across reputable institutions, it was determined that adolescents with idiopathic scoliosis who were considered to be at high risk for curve progression that would eventually warrant surgery, bracing was associated with a significantly greater likelihood of reaching skeletal maturity with a curve of less than 50 degrees, as compared with observation alone.

The study also showed a significant association between the average hours of daily brace wear and the likelihood of a successful outcome. These findings corroborate those of previous prospective observational studies, which have shown a significantly lower rate of surgery among patients who wore a brace than among those who were untreated[7]and a strong relationship between wear time and outcome.[8]


Our analysis

The BRAIST study is without a doubt one of the most important pieces of research which informs our work here at the clinic. Since we’re strongly committed to providing the latest, most up to date treatment methodologies available we welcome any and all research which can assist us in fine turning our approach to non-surgical scoliosis treatment.

BRAIST has shown conclusively that bracing is an effective way to treat scoliosis non-surgically, and also confirms a link between correctly prescribed wear time and positive outcomes. At the UK scoliosis clinic, we’re also committed to helping to find ways to treat the 25% of individuals who didn’t get the result they would have liked from the BRAIST study. One of the ways we do this is by offering what we believe is the best scoliosis bracing system available, the Scolibrace system – which is an active correction, individually customised brace designed for maximum correction. Since a variety of braces were used during this study, we hypothesise that the successful treatment figures could have been even higher if more modern concepts in brace design had been adopted for the study. You can learn more about scolibrace here.


[1] Weinstein SL, Ponseti IV. Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 1983;65:447-455

[2] Dolan LA, Weinstein SL. Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review. Spine (Phila Pa 1976;32:Suppl:S91-S100

Dolan LA, Weinstein SL. Best treatment for adolescent idiopathic scoliosis: what do current reviews tell us? In: Wright JG, ed. Evidence-based orthopaedics: the best answers to clinical questions. Philadelphia: Saunders, 2009.

Focarile FA, Bonaldi A, Giarolo MA, Ferrari U, Zilioli E, Ottaviani C. Effectiveness of nonsurgical treatment for idiopathic scoliosis: overview of available evidence. Spine (Phila Pa 1976;16:395-401

Lenssinck ML, Frijlink AC, Berger MY, Bierman-Zeinstra SM, Verkerk K, Verhagen AP. Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents: a systematic review of clinical trials. Phys Ther 2005;85:1329-1339

Negrini S, Minozzi S, Bettany-Saltikov J, et al. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2010;1:CD006850-CD006850

Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D. A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis. J Bone Joint Surg Am 1997;79:664-674

Screening for idiopathic scoliosis in adolescents. Rockville, MD: Preventive Services Task Force, June 2004 (http://www.uspreventiveservicestaskforce.org/uspstf/uspsaisc.htm).

[3] Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis: a prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am 1995;77:815-822

Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity. Spine (Phila Pa 1976;32:2198-2207)

[4] Richards BS, Bernstein RM, D’Amato CR, Thompson GH. Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine (Phila Pa 1976;30:2068-2075)

[5] Dolan LA, Weinstein SL, Adams BS. Temperature as a diagnostic test for compliance with a thoracolumbosacral orthosis. Presented at the Annual Meeting of the Pediatric Orthopaedic Society of North America, Waikaloa, HI, May 3–7, 2010 (poster).

Helfenstein A, Lankes M, Ohlert K, et al. The objective determination of compliance in treatment of adolescent idiopathic scoliosis with spinal orthoses. Spine (Phila Pa 1976;31:339-344

[6] Stuart L. Weinstein, M.D., Lori A. Dolan, Ph.D., James G. Wright, M.D., M.P.H., and Matthew B. Dobbs, M.D. Effects of Bracing in Adolescents with Idiopathic Scoliosis N Engl J Med 2013; 369:1512-1521

DOI: 10.1056/NEJMoa1307337

[7] Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity. Spine (Phila Pa 1976;32:2198-2207

[8] Katz DE, Herring JA, Browne RH, Kelly DM, Birch JG. Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Am 2010;92:1343-1352