Scoliosis Bracing – possible Side Effects With Use of Boston Brace
Numerous recent studies have challenged the use of spinal bracing for adolescent idiopathic scoliosis as a nonsurgical treatment strategy to prevent curve progression mainly due to without of empirical evidence supporting its long term effectiveness and also due to psychological problems directly credited to scoliosis brace use. The most shared scoliosis brace utilized in the United States is the TLSO thoraco-lumbar-sacral-orthosis commonly referred to as the Boston Brace. The Boston Scoliosis Brace is chiefly used for thoracic curvatures with apexes no higher than T7. Very little attention has been given to the fact that stiff braces severely restrict the mobility of the abdomen and chest wall. Studies performed by the Laboratory of Clinical Physiology Ulleval Hospital Sophies Minde Orthopaedic Hospital Oslo, Norway involving the use of the Boston Brace (TLSO) demonstrated a meaningful decline in pulmonary function both at rest and during exercise while wearing the Boston Brace.
The majority of adolescents that are prescribed spinal bracing are told to use their scoliosis brace for 23 hours daily. As we start to dissect the physiological effects we can understand why a major issue exists with compliance when wearing the Boston Brace or any other stiff brace. The amount of physical discomfort that is occurring is in most situations ignored and poorly understood. If someone were to aggressively squeeze your chest wall and then press on your abdomen and then keep up it for 23 hours daily how would you feel? The amount of functional loss to the patients breathing mechanics is upsetting and potentially dangerous. The respiratory studies indicated a meaningful decline in breathing capacity and also in oxygen and CO2 exchanges ratios causing an innate neurological breathing adaptation to take place in order to survive. Most studies however indicated that the breathing and pulmonary testing returned to normal once the brace was removed but you have to surprise what kind of cellular damage or other health implications may occur while in the scoliosis brace.
Understanding human physiology, however complicate, may be simplified to some general facts. Breathing isnt just affecting oxygen intake and gas exchange it has a major effect on other aspects of human health. Breathing has a meaningful impact on hormone regulation including estrogen, progesterone, growth hormone, and thyroid hormones. In addition breathing has a direct affect on muscle and fat composition in addition as cognitive performance. in spite of if the breathing capacity returns to normal after wearing the Boston Scoliosis Brace, we may instead want to discuss what impact it may have on a childs 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 might have on a growing body.
The Boston Brace mechanically produces pressure on both the chest wall and the abdomen allowing for little compensation within the breathing mechanism. The studies that were performed on children wearing the Boston Brace demonstrated a 30% decline in VC (vital capacity) and a 45% decline in ERV (expiratory save quantity) the same kind of decreases found in long term smokers. Symptoms related to respiratory distress may include headaches, anxiety, sleep disturbance, nightmares and cognitive dysfunction.
It is unfortunate that such an invasive treatment is often utilized in hopes of preventing scoliosis progression with little consideration of how it will affect the child during and after the treatment. Such thin minded thinking with a only focus on a Cobb angle measurement seems to stifle all other rational thought as to side effects from scoliosis bracing. With recent evidence discovered by the genetic research team at Axial Bio Tech suggesting that spinal bracing does not alter the natural course of scoliosis, empirical data demonstrating the meaningful pulmonary stress while wearing the Boston Brace combined with the known psychological problems associated with brace use, parents and their doctor must closely consider risks versus benefits when considering use of the Boston Brace.