Treatment of bracing for adolescent idiopathic scoliosis patients: a meta-analysis

  • Yuhao Zhang
  • Xingwei LiEmail author
Review Article



A meta-analysis was conducted to compare the efficacy and safety of bracing and other treatments in adolescent idiopathic scoliosis (AIS) patients.


PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials that investigated bracing and other treatments for AIS. The Mantel–Haenszel method with fixed-effects or random-effects model was used to calculate the relative risks and 95% confidence intervals (CIs). The results of heterogeneity, sensitivity analysis, and publication bias were analyzed.


Seven studies that met the eligibility criteria with 791 participants were included. The results of meta-analysis suggested significant differences between bracing and observation groups in successful outcomes [OR 3.58, 95% CI (1.92, 6.68), P < 0.0001; P for heterogeneity = 0.008, I2 = 65%], quality of life [MD = 2.13, 95% CI (0.51, 3.75), P = 0.01; P for heterogeneity = 0.89, I2 = 0%], and adverse events [OR 5.31, 95% CI (2.42, 11.66), P < 0.0001; P for heterogeneity = 0.78, I2 = 0%].


The findings of this meta-analysis suggested that bracing is efficient and safe for the treatment of AIS.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.


Bracing Adolescent idiopathic scoliosis Efficacy Safety Meta-analysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_6075_MOESM1_ESM.pptx (3.9 mb)
Supplementary material 1 (PPTX 4021 kb)


  1. 1.
    Zaina F, Negrini S, Fusco C, Atanasio S (2009) How to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria. Scoliosis 4:18. CrossRefGoogle Scholar
  2. 2.
    Lebel DE, Al-Aubaidi Z, Shin EJ, Howard A, Zeller R (2013) Three dimensional analysis of brace biomechanical efficacy for patients with AIS. Eur Spine J 22:2445–2448. CrossRefGoogle Scholar
  3. 3.
    Carus ASJSCG (2010) Early night-time-bracing—an alternative in AIS management. Scoliosis 5:O57CrossRefGoogle Scholar
  4. 4.
    Raso VJ, Lou E, Hill DL, Mahood JK, Moreau MJ (2002) Is the Boston brace mechanically effective in AIS? Stud Health Technol Inform 91:378–382Google Scholar
  5. 5.
    Mak I, Lou E, Raso JV et al (2008) The effect of time on qualitative compliance in brace treatment for AIS. Prosthet Orthot Int 32:136–144CrossRefGoogle Scholar
  6. 6.
    Lou E, Hill D, Parent E et al (2009) Prediction of curve progression for AIS patients treated with a TLSO Brace. Scoliosis 4:1CrossRefGoogle Scholar
  7. 7.
    Lou EH, Hill DL, Raso JV, Moreau M, Hedden D (2016) How quantity and quality of brace wear affect the brace treatment outcomes for AIS. Eur Spine J 25:495–499. CrossRefGoogle Scholar
  8. 8.
    Zaina F, Negrini S, Atanasio S (2009) Brace treatment can change aesthetics in Adolescent Idiopathic Scoliosis (AIS) patients. Scoliosis 4:1CrossRefGoogle Scholar
  9. 9.
    Karavidas NS (2016) Bracing for Adolescent Idiopathic Scoliosis (AIS) and Scheuermann Kyphosis: the issue of overtreatment in Greece. Scoliosis Spinal Disord 11:30. CrossRefGoogle Scholar
  10. 10.
    Varni JW, Seid M, Kurtin PS (2001) PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 39:800–812CrossRefGoogle Scholar
  11. 11.
    Goldberg CJ, Moore DP, Fogarty EE, Dowling FE (2001) Adolescent idiopathic scoliosis: the effect of brace treatment on the incidence of surgery. Spine 26:2058CrossRefGoogle Scholar
  12. 12.
    Gozde G, Burcu D, Cigdem A et al (2015) Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: a preliminary analysis. Gait Posture 41:93–99CrossRefGoogle Scholar
  13. 13.
    Piantoni L, Tello CA, Remondino RG et al (2018) Quality of life and patient satisfaction in bracing treatment of adolescent idiopathic scoliosis. Scoliosis Spinal Disord 13:26CrossRefGoogle Scholar
  14. 14.
    Shifu S, Zezhang Z, Xu S et al (2013) Effectiveness of brace treatment of Chiari malformation-associated scoliosis after posterior fossa decompression: a comparison with idiopathic scoliosis. Spine 38:E299CrossRefGoogle Scholar
  15. 15.
    Ugwonali OF, Lomas G, Choe JC et al (2004) Effect of bracing on the quality of life of adolescents with idiopathic scoliosis. Spine J 4:254–260. CrossRefGoogle Scholar
  16. 16.
    Weinstein SL, Dolan LA, Wright JG, Dobbs MB (2013) Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 369:1512–1521. CrossRefGoogle Scholar
  17. 17.
    Chalmers E, Hill D, Zhao V, Lou E (2015) Prescriptive analytics applied to brace treatment for AIS: a pilot demonstration. Scoliosis 10:1–4CrossRefGoogle Scholar
  18. 18.
    Knott P, Techy F, Cotter T et al (2013) Retrospective analysis of immediate in-brace correction of scoliosis attainable in patients with AIS: a SOSORT initiative. Scoliosis 8:O49CrossRefGoogle Scholar
  19. 19.
    Romano M, Negrini A, Pizzetti P, Negrini S (2010) A retrospective controlled cohort study in 176 patients on the efficacy of SEAS exercises in AIS treatment: brace prescriptions, and radiographic and clinical outcomes at the end of growth. Scoliosis 5:O25CrossRefGoogle Scholar
  20. 20.
    Al-Aubaidi ZT, Tropp H, Pedersen NW, Jespersen SM (2013) Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients—compliance and satisfaction. Scoliosis 8:6. CrossRefGoogle Scholar
  21. 21.
    Chalmers E, Hill D, Donauer A, Tilburn M, Zhao V, Lou E (2015) How does pressure configuration affect Cobb angle during AIS brace casting? Scoliosis 10:1CrossRefGoogle Scholar
  22. 22.
    Lou E, Hill D, Raso J, Moreau M, Mahood J, Hedden D (2009) An early stage brace wear pattern during daily activities for AIS. Scoliosis 4:1CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedicsthe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
  2. 2.Department of Bone and Joint RehabilitationYunnan Province Disabled Rehabilitation CenterKunmingChina

Personalised recommendations