Back brace

A back brace is a device designed to limit the motion of the spine in cases of fracture or in post-operative fusions, as well as a preventative measure against some progressive conditions.

Common back braces include:

Back braces are also commonly prescribed to treat adolescent idiopathic scoliosis, as they may stop the progression of spinal curvature in a growing child/adolescent. In some cases, the back brace may also help decrease the amount of curvature in the spine. A variety of brace styles are available; the Boston brace is the most commonly used brace for adolescent idiopathic scoliosis (AIS). Other designs include the Milwaukee brace, the Charleston bending brace, the Peak Scoliosis Bracing System, and the SpineCor (a soft brace) in the United States, Canada and Europe. In Europe, however, the SPoRT and Cheneau and Crass Cheneau braces are also used. There has been considerable research and information published in reputable journals on back braces for scoliosis. Issues like patient compliance with treatment, psycho-social impact of brace use, and exercise with bracing have been looked at. Quality of Life research has been attempted, but is difficult due to a current lack of instruments. Bracing is the primary treatment for AIS in curves that are considered to be moderate in their severity and are likely due to progress (determined by curve pattern/type and the patient's structural maturity).

One large issue in bracing for scoliosis is patient compliance, as mentioned above. Compliance is often impacted by the other above-mentioned factors (psycho-social comfort, exercise), but there are others also, including ability to eat and move, pain, and physical deformation. Back braces, especially the Boston brace, puts a great deal of pressure on the abdomen and can make digestion uncomfortable. Scoliosis braces, like those used for correcting post-operatively and for fractures, inhibit motion to a large extent, though percentages are difficult to find. Patients frequently complain about the inability to tie their own shoes, sit on the floor, etc. Bracing is also painful, though the body can adapt to tolerate the pain. Braces can also deform the patient's existing bone structures, most notably the hips, though there have been complaints about rib cage deformities as well.

A Boston brace is a form of thoracolumbosacral orthosis (TLSO). It is the most commonly used brace in the United States. It is a symmetrical brace. It corrects curvature by pushing with small pads placed against the ribs, which are also used for rotational correction (here it tends to be slightly less successful, however). These pads are usually placed in the back corners of the brace so that the body is thrust forward against the brace's front, which acts to hold the body upright. The brace opens to the back, and usually runs from just above a chair's seat (when a person is seated) to around shoulder-blade height. Because of this, it is not particularly useful in correcting very high curves. It also does not correct hip misalignment, as it uses the hips as a base point. This brace is typically worn 20–23 hours a day.

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