Results of Charleston bracing in skeletally immature patients with idiopathic scoliosis

Previous studies have reported varying success rates with the use of the Charleston brace in idiopathic scoliosis. However, these studies have included patients from multiple centers, those with double curves, and those still undergoing treatment. This article presents the results of Charleston bracing in 42 skeletally immature patients (Risser 0/1) treated at one institution and followed up for a mean of 3.3 years after brace discontinuation. Selection criteria included a diagnosis of idiopathic scoliosis, Risser stage 0 or 1, at least 10 years of age at the time of bracing, female gender, a single curve between 25 degrees and 40 degrees, and no prior treatment. The average age at the time of bracing was 12.5 years (range 10-15) and the average curve was 30.3 degrees (range 25 degrees -40 degrees ). Outcome was considered a failure if the curve had increased more than 5 degrees at last follow-up, if surgical intervention was required, or if there was a change of orthosis during treatment (e.g., Charleston to Boston). In 25 of the 42 patients (60%), the brace was successful in preventing progression of the curve (mean follow-up 3.4 years; range 1.1-11.7). Thoracic curves had the same success as thoracolumbar and lumbar curves. Based on these results, the authors conclude that the Charleston brace is effective in preventing progression of curve. Proper patient selection is important.