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A Breakthrough Study on Bracing in Scoliosis

Dr. Stuart Weinstein recently reported the results of the NIH-funded Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) at the 48th Annual Meeting of the Scoliosis Research Society in Lyon, France.  Simultaneously, the results were published online in the New England Journal of Medicine.  Dr. Weinstein reported that bracing of adolescents with moderate scoliosis was effective treatment in the reduction of the number of patients who advance to the need for surgery. In addition, a dose response was found between the number of hours of brace wear and the success rate of bracing.

Several medical centers worked together to perform the highest level of medical study, a randomized clinical trial, to answer the question of whether bracing is effective in growing children and adolescents with curves between 20 – 40 degrees.  242 patients participated in the study.  Patients in the bracing group were assigned to wear a brace 18 hours per day (a typical bracing prescription).  A special monitor was embedded in the brace to keep track of how long it was used per day.  Patients in the observation-only group received no additional treatment.  The end point of the study was “treatment failure” defined as progression of the scoliosis to =50 degrees or “treatment success” when skeletal maturity was reached without progression to 50 degrees.

72% of brace wearers avoided surgical recommendations, but only 48% of patients in the observational group. Furthermore, the rate of success achieved by those patients who wore the brace for 13 hours or more was greater than 90%, showing that the amount of time the brace is worn is very important.  The study provided strong evidence to the value of brace treatment for those adolescents at high risk of progression of surgery.

n the past, the value of a screening examination for scoliosis has been debated due to inconclusive evidence of the success of non-operative treatment for scoliosis. This is no longer true as the evidence from the BrAIST study establishes the effectiveness of bracing as early, non-operative care.  This may reduce the number of patients who progress to surgery and serve as a potential cost saving for the health care system and of great benefit to patients. Policy statements from professional organizations and governmental agencies regarding scoliosis screening in school programs and primary care settings will need to be reassessed in order to identify at-risk patients who will benefit from bracing for scoliosis.

This study was recently featured in the New York Times.

Download a PowerPoint Presentation on the BrAIST study and results by clicking here.

SOURCE: https://www.srs.org/professionals/online-education-and-resources/braist-presentation


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Practice Policy Update Regarding COVID-19

Dear Patients:

Our patients, employees and family are our top priority at Long Island Spine Specialists, P.C.

We ask you to not visit any of our locations if you have symptoms such as fever, sneezing, coughing and possible shortness of breath.

Please cancel your appointment and re-schedule once you are feeling better and are no longer suffering with symptoms.

Only non-symptomatic patients will be seen. No exceptions.

Accompanying family members – including children – are asked to remain in the waiting area and will not be allowed to enter the exam rooms.

During this time of high concern regarding the spread of COVID-19 (Coronavirus) we are taking extra precautions to maintain the highest possible standards of safety and cleanliness. Please be advised that we are carefully following recommendations from both the CDC and WHO and are here to help guide you through this time if needed.

Some steps we are taking to keeping safe:

  1. We know how important cleanliness is and always maintain the highest standards of cleanliness. To further offer you peace of mind, we have increased the frequency of the cleaning of our office.
  2. Rest assured that hand washing is strictly followed. Hand sanitizer is available to all staff and patients.
  3. Additionally, if you have recently traveled to a country with high rates of the coronavirus or have been on a cruise, please reschedule your visit for at least 14 days from your return date. We will gladly accommodate your needs to reschedule. At that time, a telehealth interface can be arranged if necessary.

Find up-to-date and accurate information on the Centers for Disease Control and Prevention (CDC) website and feel free to reach out with questions.

- Your team at Long Island Spine Specialists, P.C.

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