After the doctor diagnoses scoliosis and obtains an X-ray of the spine, an assessment is made as to whether the child needs a brace application. Depending on the skeletal maturity according to the Risser scale (iliac apophysis), it is determined whether the patient is in the phase of rapid growth and development. If so, this information tells us that the child is in a period when the curve can progress rapidly. Based on the size of the scoliotic curve and skeletal maturity, the doctor decides whether the treatment should also include wearing a brace. When the curve is greater than 20-25 degrees according to Cobb and Risser 0-3, the patient is referred to an orthotist who makes the brace.

An orthotist must have a specific and deep knowledge of the 3D nature of idiopathic scoliosis and have extensive experience in correcting the scoliotic curve. When putting on the brace for the first time, the child is assisted by an orthotist, who closes the brace in a lying position on the back, after which he gives detailed instructions for wearing and getting used to it. After applying the brace, what the patient can feel is more or less pressure at the points of contact with the pads (on the convex sides), depending on the flexibility of the curve. The pressure produces physical discomfort, depending on the sensitivity of the patient. Changing the posture of the trunk can create neurological problems by suddenly changing the body pattern without adjustment. The orthotist gives instructions on how much the brace should be tightened and therefore marks the straps on the front. Every day, the child wears the brace a little longer than the previous day. After two weeks it should reach full time (20-23 hours) wearing the brace. In order to fulfill the hours of wearing, the brace should be worn during the day and during the night. The effectiveness of wearing a brace is greater during the day, especially at school while the child is sitting. During the night, the body is relieved and therefore it can be considered that the possibility of progression is lower.

It is mandatory to follow the instructions for placing and wearing the brace provided exclusively by the orthotist. After a month of “full time” wearing of the brace, an X-ray is taken in the brace, in order to determine its effectiveness. Brace controls are mandatory and agreed upon, in order for the brace to be re-controlled in a timely manner and adapted to changes resulting from growth and development. When the brace becomes small due to growth and development, the doctor prescribes the creation of a new brace.

In order to achieve the best results, it is necessary to engage a multidisciplinary team (doctors, physiotherapists and orthotists) who work together to achieve the same goal.