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Bracing is used to treat structural kyphosis, especially Scheuermann's kyphosis (also known as Scheuermann's disease). It is not used for postural kyphosis, but it is used for some spinal fractures.
Bracing for Scheuermann's Kyphosis
Before recommending bracing for Scheuermann's kyphosis, the doctor will take several factors into consideration:
the patient's age
how much growing the patient has left to do: if the patient is done growing, the brace won't do much good in terms of stopping curve progression
the severity of the kyphotic curve: bracing is usually recommended for curves greater than 70º
how likely it is that the curve will get worse: because if the curve is already severe and the Scheuermann's patient hasn't gone through his or her adolescent growth spurt, it will most likely get much worse when he or she does grow
how much vertebral wedging there is: in Scheuermann's kyphosis, the front of the vertebrae don't grow as fast as the back of the vertebrae, so they end up wedge-shaped
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A brace can help control pain, and it can slow or stop the curve's progression. A brace may help a patient avoid surgery later on. It's designed to hold the spine straight—chin up, shoulders back—and to take pressure off the vertebrae. In Scheuermann's kyphosis, the vertebrae are then better able to grow as they should; the front of the vertebrae can "catch up" with the back of the vertebrae, in terms of development.
There are different types of braces, and the doctor will carefully select the appropriate option for the patient. The brace will then be custom-fitted, to ensure that it fits comfortably.
The doctor or nurse will discuss with the patient how to wear the brace, for how long each day, and for how many weeks or months. At first, patients may need to wear the brace for more than 20 hours each day (yes, even up to 24 hours a day).
Wearing a brace can be hard because it may feel uncomfortable at first. It may take some time to adjust to how the brace looks and feels. However, the doctor or nurse will give some helpful tips on how to make the brace as comfortable as possible. For the brace to be as effective as possible, it's absolutely necessary to follow the doctor's orders exactly. Getting a teenager to stick with the bracing plan can be especially difficult because—at a time when it's very important to be cool—the brace usually doesn't make them feel all that cool.
However, by always wearing the brace and wearing it correctly, the patient may be able to avoid more invasive treatments (i.e., surgery). This possible benefit—and general spinal health—should outweigh any issues with the brace.
Bracing for Spinal Fractures
If you have mild or moderate compression fractures, your doctor may recommend bracing to immobilize your spine as the bones heal. This should prevent you from developing a more severe curve. Generally, patients with spinal fractures wear a brace to six to twelve weeks, although the exact timeframe is up to your doctor.
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