A COMPARISON BETWEEN THE BOSTON BRACE AND THE CHARLESTON BENDING BRACE IN ADOLESCENT IDIOPATHIC SCOLIOSIS

Study Design. The authors studied 319 patients with adolescent idiopat hic scoliosis treated at the same institution with either a Boston bra ce or a Charleston bending brace. Objectives. To determine if both ort hoses are equally effective in stopping curve progression and preventi ng the need for surgical correction. Summary of Background Data. Early reports suggest that the Charleston brace may be comparable to the Bo ston brace in its effectiveness and that both braces positively influe nce the natural history of idiopathic scoliosis. Methods, Skeletally i mmature (Risser 0, 1, or 2) patients with idiopathic scoliosis who wer e 10 years old or older at the time of brace prescription, had curves from 25 degrees to 45 degrees, and had no prior treatment were studied retrospectively. All measurements were collected by a single observer , and all patients were followed up to skeletal maturity. Results, The Boston brace is more effective than the Charleston brace, both in pre venting curve progression and in avoiding the need for surgery. These findings were most notable for patients with curves of 36 degrees-45 d egrees, in whom 83% of the those treated with a Charleston brace had c urve progression of more than 5 degrees, compared with 43% of those tr eated with the Boston brace (p < 0.0001). Conclusion. When given the c hoice between these two orthoses in the treatment of adolescent idiopa thic scoliosis, the authors recommend use of the Boston brace. The Cha rleston brace should be considered only in the treatment of smaller si ngle thoracolumbar or single lumbar curves.