Scoliosis occurs in Adolescent person. It requires treatment when the curve is significant that is greater than 20-25 degrees in a child who is still growing. Illustration by X-rays labeling age. The adolescent means a person is in the growing phase of bodily development.

Brace treatment is effective with level I evidence of success. (1,2) It is however, a treatment demanding great effort from everyone involved as it requires a few essential elements for it to achieve success.

It is important to understand the basic abnormality in scoliosis development is an asymmetrical growth of an affected region of the spine an d the trunk. Studies on brace success showed curve correction is the first important element. This is logical as the treatment intervention should reverse or stop the
abnormal growth environment. Corrective brace fabrication and special features How to achieve curve Correction is a very complex process requiring appropriate application of corrective forces by a corrective brace specific for an individual person.(5,6,8,9) The application of specific force in brace is made possible by planned moulding and application of external forces to mould a tailor made brace.

The second essential element is to make the brace comfortable patient friendly to use. The specific moulded brace are secured with anterior self fastening tension straps to hold the spine in corrected position. There would be pressure at the interface areas between the brace and the body region in contact. Multiple adjustments are therefore required to minimize the pressure that can cause pain and discomfort and when the pressure is high and persistent sore may develop. Many strategies are required to relief the discomfort such as addition of cushioning pads, re-moulding and trimming of edge of brace, reduction of the degree of tension and allowance of brief period of off brace rest to allow maximal compliance with the prescribed treatment time. The understanding of how to use the brace would be an important element of success.

Having achieved curve correction and comfortable brace, the third element is the maintenance of the correction and brace wear duration to maintain the corrective growth environment. Multiple studies showed brace success required treatment time for at least 12 hours of the day minimum.(3,4,7,10) It is
common sense that the longer the duration of the spine in corrected position the longer would be the corrective growth effect. It is therefore important for patient and parents to understand the importance of wear time and compliance with treatment.