Numerous recent studies have questioned the use of spinal corsets for adolescent idiopathic scoliosis as a non-surgical treatment strategy to prevent curve progression, mainly due to a lack of empirical evidence to support their long-term effectiveness and also due to problems psychological problems directly attributed to the use of a brace for scoliosis. The most common scoliosis brace used in the United States is the TLSO thoraco-lumbar-sacral orthosis, commonly known as the Boston Brace. The Boston Scoliosis Brace is used primarily for thoracic curvatures with vertices no greater than T7. Very little attention has been paid to the fact that rigid braces severely restrict mobility of the abdomen and chest wall. Studies conducted by the Laboratory of Clinical Physiology Hospital Ulleval Sophies Minde Orthopedic Hospital Oslo, Norway, involving the use of the Boston Brace (TLSO), demonstrated a significant decrease in lung function both at rest and during exercise while wearing the Boston Brace. .
Most teens who are prescribed a spinal brace are told to wear their scoliosis brace for 23 hours a day. As we begin to dissect the physiological effects, we can understand why there is a significant problem with compliance when using the Boston Brace or any other rigid brace. In most cases, the amount of physical discomfort that occurs is ignored and poorly understood. If someone were to aggressively squeeze your chest wall and then press on your abdomen and then hold it for 23 hours a day, how would you feel? The amount of functional loss of the patient’s respiratory mechanics is disturbing and potentially dangerous. Respiratory studies indicated a significant decrease in respiratory capacity and also in oxygen and CO2 exchange ratios, leading to innate neurological respiratory adaptation in order to survive. However, most studies indicated that respiratory and lung tests returned to normal once the brace was removed, but you have to wonder what kind of cell damage or other health implications can occur while wearing the brace. for scoliosis.
Understanding human physiology, however complex, can be simplified to a few general facts. Breathing not only affects oxygen intake and gas exchange, but has a major effect on other aspects of human health. Breathing has a significant impact on hormonal regulation, including estrogen, progesterone, growth hormone, and thyroid hormones. Additionally, breathing has a direct effect on muscle and fat composition, as well as cognitive performance. Regardless of whether breathing ability returns to normal after wearing the Boston Scoliosis Brace, we may want to discuss what impact it may have on a child’s health while wearing it. There are currently no known studies addressing this issue, but it would certainly be interesting to see how much of an impact restricting breathing capacity for 23 hours a day could have on a growing body.
The Boston Brace mechanically produces pressure on both the chest wall and abdomen, allowing for small compensation within the breathing mechanism. Studies conducted on children wearing the Boston Brace demonstrated a 30% decrease in VC (vital capacity) and a 45% decrease in ERV (expiratory reserve volume), the same type of decrease found in long-term smokers. Symptoms related to respiratory distress can include headaches, anxiety, sleep disturbances, nightmares, and cognitive dysfunction.
It is unfortunate that such an invasive treatment is often used in the hope of preventing the progression of scoliosis without regard to how it will affect the child during and after treatment. Such narrow-minded thinking with a single focus on measuring the Cobb angle seems to stifle all other rational thinking as to the side effects of scoliosis braces. With recent evidence uncovered by Axial Bio Tech’s genetic research team suggesting that the spinal brace does not alter the natural course of scoliosis, empirical data demonstrating significant lung stress while wearing the Boston Brace combined with psychological issues known risks associated with brace use, parents and their physician should carefully consider the risks versus benefits when considering the use of the Boston Brace.
