Even When Bracing Fails to Prevent Surgery, It May Improve the Lumbar Curve in Patients with Adolescent Idiopathic Scoliosis.

Bracing decreases curve progression in adolescent idiopathic scoliosis (AIS). However, many curves still progress to a surgical range. The purpose of this study was to evaluate the effects of bracing on the lumbar curve in AIS patients who required posterior spinal fusion (PSF) for thoracic curves that progressed. The records of 432 patients with AIS who underwent PSF from 2005 to 2015 were reviewed. Braced/unbraced patients were matched 1:1 for age, Lenke type, and preoperative thoracic major curve. The unbraced group had a mean lumbar curve (44°) that was greater than the braced group (34°) (p < 0.001), the proportion of Lenke 1A curves was higher in the braced group (81% vs. 39%, p < 0.001), and the unbraced group had greater odds (odds ratio [OR] = 2.3; confidence interval [CI]: 1.2 - 4.5) of spinal fusion caudal to L1. Patients in the braced group had more favorable Lenke lumbar modifiers (type A), smaller preoperative lumbar curves, and fewer fused lumbar vertebrae compared with the unbraced group. (Journal of Surgical Orthopaedic Advances 34(2):082-085, 2025).