ARISE the Scoliosis Research Trust

ARISE – The Scoliosis Research Trust

Information Sheet 9

SCOLIOSIS BRACING

T.L.S.C.O. (Thoraco-Lumbar Scoliosis Corrective Orthosis)

Braces are normally supplied when a curve is seen to progress. The objective of the brace is to redirect the growth of the scoliotic spine.

Many types of brace can be prescribed by the Orthopaedic Surgeon. The standard type of brace for scoliosis is a custom-built T.L.S.C.O.

In order to make a brace, a plaster cast of the patient has to be taken by an orthotist. This is normally done with the patient sitting down although in the case of patients with cerebral palsy or muscular dystrophy, the cast is sometimes taken with the patient on a lying down frame. A thin stockinet vest is provided for the patient to wear and Plaster - of - Paris bandages are applied directly onto this. The plaster gets quite warm as it is hardening up and is removed immediately. The whole process takes less than 10 minutes.

The cast is then sent to the factory for the brace to be manufactured. The interval of time between casting and delivery of the brace is usually 4 weeks.

An appointment is then arranged for the patient to visit the Orthotics department to have the brace fitted and this normally takes about 3 hours. The brace is trimmed and adjusted at this time to suit the patient's individual needs. Various types of pads are incorporated into the brace to give support and to help the spine grow straight.

The patient is advised on a brace-wearing routine in accordance with the consultant's instructions. We

normally ask our patients to wear the brace for half an hour on the first day, one hour on the second day and to gradually increase the time that the brace is worn during the next ten days until it is worn routinely for most of the day and night.

Care must be taken with the skin and any redness or soreness should be reported to the orthotist.

When the patient is approaching skeletal maturity - which is not the same as the chronological age or emotional maturity - the period of brace-wearing is reduced until the brace is discarded although regular check-ups by the orthopaedic surgeon will still be necessary.