When treating a child or teen with a curvature of the spine, doctors will often recommend bracing as a way of halting the curve’s progression.
Back braces come in a variety of forms, each designed to prevent/minimise curvature development while the patient grows. Here, we look at two of the most well-known brace types: the Milwaukee brace and the Boston brace.
Milwaukee brace
The Milwaukee brace may be prescribed to individuals who possess high thoracic (upper back) curves. It has an unusual design that is intended to manipulate the patient’s full upper body: the brace extends from the pelvis all the way up to the neck, and it’s manufactured with a contoured plastic pelvic girdle and neck ring, connected by a metal bar in both the front and back of the brace.
These metal bars play an important role, helping the torso extend while the neck ring keeps the head in a central position over the pelvis. Pressure pads are strategically attached to the metal bars with straps in accordance with the shape of the patient’s spinal curvature.
The Milwuakee brace (first developed in 1945 by Dr Albert Schmidt and Dr Walter Blount of the Medical College of Wisconsin and Milwaukee’s Children’s Hospital) is viewed by many as the first modern brace designed for the treatment of scoliosis. It has undergone a number of tweaks over the years, although the current design has been in use since 1975.
The Milwaukee brace is far less common now that form-fitting plastic braces are available. However, it is still prescribed for some scoliosis patients with curves located very high in the spine.
Boston brace
The Boston brace was first developed in the early 1970s by Mr William Miller and Dr John Hall of The Boston Children’s Hospital. It is a a type of thoracolumbosacral orthosis (TLSO), and it’s one of the most commonly-used brace options when it comes to treating scoliosis.
TLSO braces are commonly referred to as ‘underarm’ or ‘low-profile’ braces. The Boston brace is much smaller and far less bulky than the Milwaukee brace, with plastic components custom-made to fit the patient’s body exactly. The Boston brace covers most of the torso; at the front, it starts below the breast and extends all the way to the beginning of the pelvic area, while at the back, it starts below the shoulder blades all the way down to the tail bone of the spine.
This type of brace works by applying three-point pressure to the curve pattern in order to prevent further progression. This forces the lumbar areas to ‘flex’, pushing in the abdomen and flattening the posterior lumbar curve.
ScolioGold therapy and other treatments
If you’ve been diagnosed with scoliosis (or another curvature of the spine) and wear a back brace to help halt the progression of your curve, it is a good idea to undergo specialised physiotherapy as well. The sole purpose of a back brace is to stop the curve in your spine worsening during periods of growth; it does very little to assist in the building of the muscles needed for stability once the brace has been removed. To learn more about the specialised treatment courses for brace wearers that we offer here at the Scoliosis SOS Clinic, please click here.
In some cases, the treatment courses that we deliver can eliminate the need to wear a brace altogether! Please use the links below to find out more and book your Scoliosis SOS consultation.
Our Treatment Methods > Contact Scoliosis SOS >
Did you know that our therapists can provide ScolioGold therapy in your own home?
ScolioGold treatment is a non-invasive, exercise-based alternative for patients who are suffering from scoliosis and other spinal problems. The therapy course is specifically tailored to the size and shape of the individual’s curve, and it helps to:
- Prevent further progression
- Improve cosmetic appearance
- Reduce pain
- Give patients the opportunity to avoid spinal fusion surgery
The Scoliosis SOS Clinic is located in central London, and although patients do travel from all over the world to receive treatment here, we understand that it is not always possible for patients to travel to London.
In these cases, our staff will travel to you.
Home treatment with your ScolioGold therapist
Our highly-experienced therapists have travelled all over the world to treat patients in their own homes. The USA and East Asia are just two of the locations they have visited for this purpose.
Although we encourage our patients to attend the clinic where possible, intensive one-to-one treatment on location has proven to be just as successful. Our ScolioGold consultants give the patient a full medical assessment over the telephone to confirm their suitability, and a personalised course of treatment is prescribed.
If a patient decides that they would like to be treated in their own home, we then discuss suitable dates and make accommodation and travel arrangements. Patients are required to have some equipment sent to their home address in order to get the most out of their treatment.
Who is eligible for home treatment?
Treatment on location is available to patients of all ages as long as they are able to follow instructions and have enough mobility to get up off the floor unaided. Our therapists will travel to most countries to treat patients, and have also travelled to other parts of the United Kingdom to treat patients who were unable to travel to London.
ScolioGold treatment isn’t just for patients with scoliosis and hyperkyphosis – it is also suitable for patients with postural problems, as well as for those who suffer from chronic back pain.
What level of treatment will be provided?
The amount of 1:1 treatment required will depend on the patient’s age and the severity of their spinal curve. This will be discussed prior to booking. On-location treatment means that our therapists can work around your school/work commitments.
To discuss treatment options and arrange an initial telephone consultation, please contact us online or call 0207 488 4428.
If you suffer from scoliosis, you will probably have looked into the various treatment options for this condition. Today, we’re going to look at the pros and cons of one specific treatment method: spinal fusion surgery using Harrington rods.
What are Harrington rods?
Developed in the early 1960s by Dr Paul Harrington, the Harrington rod is a straight rod that contains a ratcheting mechanism. These rods are used in spinal fusion surgery to reduce the curvature of the patient’s spine.
The rod is positioned along the concavity (inside) of the spinal curve and attached to the spine using two hooks – one attached to a vertebra at the bottom of the curve and the other to a vertebra at top of the curve. Then, employing the ratcheting mechanism, the surgeon stretches the spine to straighten the curve and fuses into position.
Do Harrington rods help to correct scoliosis?
For 20 years, Harrington rods were seen at the ‘gold standard’ for spinal fusion surgery – if you underwent spinal fusion surgery before the year 2000, the surgeon most likely used Harrington rods. This procedure was routinely recommended for any patients with a spinal curve exceeding 45 degrees.
These days, however, there are a number of alternatives for scoliosis patients who require surgery. You can read about these more modern methods here.
Harrington rods have been successful in many cases of scoliosis, but they also come with a number of risks and limitations.
What are the risks and limitations of Harrington rods?
As with all surgical operations, there are risks involved with the procedure described above. This intrusive operation requires the surgeon to remove spinal discs and muscle so that the rod can be inserted and screwed onto the vertebrae. The spine is then bent forcefully and fused into that position. Infection is one possible complication – other potential risks include:
- Bending and breaking of the rod
- Hardware migration
- Pseudoarthrosis
- Flat back syndrome
Furthermore, this surgery is not recommended for patients whose spines are still growing. Performing a spinal fusion on a growing child can lead to a number of complications, such as the Crankshaft phenomenon. As young spines continue to grow there is a chance the spinal curve will also change, which may mean the rod will end up causing further complications.
What are the alternatives to surgery?
In some very severe cases, surgery is the only way to ensure that a spinal curve will not get any worse. In most cases, however, there are plenty of other scoliosis treatment methods available that do not involve intrusive, potentially risky surgical procedures.
Here at the Scoliosis SOS Clinic, we offer a non-surgical scoliosis treatment programme called ScolioGold therapy, which combines a number of effective techniques to improve patient’s condition. To see how effective non-surgical treatments can be, have a look at our results and see how we have reduced our patients’ Cobb angles without surgical intervention.
If you have any more questions about scoliosis surgery and how our non-surgical approach can help you with your back condition, please get in touch today.
