The classical and a modified Boston Brace: Description and results

Abstract

Idiopathic scoliosis (IS) is characterized by the lateral deviation of the spine and constitutes a three-dimensional distortion that leads to geometric and morphological lesions in the spine and thoracic cage. The most widespread method of conservative management is to use spinal orthoses or body braces. These are usually recommended in patients with skeletal immaturity with a Risser sign 2 or less and with curves ranging from 25° to 45°. Of these, perhaps one of the most popular in recent years is the Boston Brace. It was developed in the early 1970s, and its design is based on symmetry, consisting of extensions and pads, with each of them exerting corrective forces and has a specific role depending on the type of scoliosis. It is important that the treatment group, the patient, and the family environment should work as a team consistently and be well trained to achieve the best result. Various studies published in international literature have observed beneficial effects from the use of the Boston system. Nevertheless, there are still issues that need further investigation regarding its effectiveness depending on the type of curves, the duration of application, the gender, and BMI of patients to whom it is applied. However, without question, if all these factors are taken into account and with the compliance of the therapy group with the instructions, the main goal can be achieved, which is the stability of the spine, and the ultimate result of clinical-radiological and aesthetic improvement, which is directly linked to the psychological satisfaction of the patient.