The adult scoliosis brace treatment objectives are:

• Pain relief
• Postural support
• Prevention of progression of postural change
• Postural improvement

Before your first appointment at Hampshire Orthotics for assessment and measuring for scoliosis bracing you need to provide:

1. A diagnosis from a spinal consultant (because not all types of scoliosis are suitable for a brace and may require medical treatment instead). The consultant should be an orthopaedic spinal surgeon working in the NHS (via referral from your GP) or private.   Hampshire Orthotics works with private spinal consultant Mr Michael Quaye at Spire Southampton. 023 8254 3444
2. Recent X-rays of the spine (less than 6 months old)

X-rays/EOS scan

2 X-rays are needed: “full spine PA” and “full spine lateral”.

These should cover the area from T1 (top of thoracic spine) to the pelvis and extend to the rib margins.

The X-rays must be taken in standing, in your preferred position (which can be with one or both knees bent if that is how you normally stand)

X-rays can be done free of charge at your local NHS hospital by referral from your spinal consultant. You will need to ask for the X-rays to be sent to Hampshire Orthotics by email link or on a CD or given to you so that you can forward them to Hampshire Orthotics.

X-rays can be provided by a private hospital, e.g. Spire hospital after a spinal consultant has seen you. In Southampton I work with Mr Quaye. https://www.spirehealthcare.com/spire-southampton-hospital/

The alternative is an EOS scan which gives a much lower dose of radiation. https://www.alliancemedical.co.uk/modalities/eos-ct. The nearest location for EOS scans is London (Harley St). Please let Lucy know if you would like an EOS scan so that a request form can be sent.

The X-rays or EOS scans need to be analysed before your first assessment appointment.

What to expect at the initial appointment

At the initial appointment you will have a clinical assessment. For this you will need to undress down to underwear (standard bra or sports type for females). Your skin will be marked using a make-up pencil and photos will be taken. Your height and weight will be measured.

Your leg lengths will be assessed, and you may be supplied with a shoe lift as part of your treatment.

If a scoliosis brace treatment is thought to be appropriate for you, the different brace options suitable for your spine will be discussed with you. You will then be measured for the brace in a relaxed standing position and/or lying down position. You may be scanned using a 3D scanner.

Brace fitting appointment (visit 2)

2 - 3 weeks later, the brace will be fitted, and you will be shown how to correctly apply it. You will be given a weaning in programme.

Exercise programme

Scoliosis exercises are an optional addition which may help to improve your posture and reduce pain. Details of the nearest accredited scoliosis exercise provider in your area will be provided to you.

Follow up appointments

Your first review appointment (visit 3) will take place after you have been wearing the brace for about 1 month. The brace will be checked and adjusted if required. Then reviews are every 3 months. The cost of the brace includes reviews up to one year total.

After this, review appointments are chargeable and are recommended every 3 to 6 months.

Further X-rays/EOS scans in brace or out of brace may be necessary to evaluate curve progression or when a new brace is needed.

Frequency of brace wearing

For adults, the number of hours to wear the brace is variable depending on pain levels. The adult scoliosis brace wearing advice options are:

• The brace can be worn only when needed
• or it can be worn for 8 – 12 hours per day
• or it can be worn only when active, i.e. during the day at work or gardening etc
• or it can be worn full time, i.e. 20 hours for those with severe or constant pain or where there is a high risk of curve progression

How long does the brace have to be used?

• The brace can be discontinued if there is a complete resolution of symptoms.
• When the aim is to prevent progression after adolescence, then treatment can continue up to 2 years.
• For bracing that gives pain relief, then brace use can continue for many years.
• If there isn’t any pain relief after 6 months of wear and this is the only objective, then brace use should discontinue.