Work

Immediate Height Gain During Scoliosis Brace Fitting as a Predictor of In-brace Skeletal Correction: a Non-radiographic Clinical Indicator

Year: 2026

Type: article

Abstract: BACKGROUND: Spinal curvature in adolescent idiopathic scoliosis (AIS) is associated with a reduction in standing height. While height loss due to scoliosis and height gain following surgical correction are well described, little is known about immediate height change during scoliosis brace fitting and its relationship to in-brace skeletal correction. In-brace Cobb angle correction remains a primary indicator of brace effectiveness; however, no radiation-free clinical tool exists to support early assessment during fitting. OBJECTIVE: To investigate whether immediate standing height change during scoliosis brace fitting is associated with in-brace Cobb angle correction. METHODOLOGY: A retrospective audit was conducted on 60 adolescents with idiopathic scoliosis (13 males, 47 females; mean age 12.4 ± 1.7 years; mean standing height 156.6 ± 10.7 cm) treated at The London Orthotic Consultancy in Kingston, UK. Clinical data were collected between January and October 2022. Standing height was measured immediately before and after brace fitting, and Cobb angles were assessed at baseline and in-brace. Correlation and simple linear regression analyses were performed to explore the relationship between height change and in-brace correction. RESULTS: The mean baseline Cobb angle was 38.0 ± 10.7°, correcting to a mean in-brace Cobb angle of 10.3 ± 9.4°, corresponding to a mean absolute Cobb angle correction of 27.8 ± 9.9° and mean percentage correction of 74.3 ± 19.2%. Mean height gain at fitting was 1.24 ± 0.74 cm (range −0.2 to 3.5 cm). Descriptive analyses included the full cohort (n = 60), including participants demonstrating radiographic over-correction (n = 6). Following exclusion of cases demonstrating radiographic over-correction (>100%), a moderate positive association was observed (R = 0.45, p = 0.001). Sex-specific subgroup analysis was not performed due to limited statistical power. CONCLUSION: Immediate height gain during scoliosis brace fitting demonstrates a moderate association with in-brace skeletal correction and may serve as a simple, radiation-free clinical indicator of mechanical brace response. Height measurement should be interpreted as an adjunct to, rather than a replacement for, radiographic assessment. Prospective studies using multivariable predictive models are warranted to further evaluate its clinical utility. Layman's Abstract Scoliosis is a condition in which the spine curves sideways. In children and adolescents, this curvature can make a person appear slightly shorter because the spine is not fully upright. One of the main goals of brace treatment is to straighten the spine as much as possible while the child is still growing. Currently, the main way to check how well a brace is working is by taking an X-ray, but repeated X-rays expose young patients to radiation. This study explored whether a simple measurement, standing height, could provide useful information during a brace fitting appointment without using radiation. We reviewed the clinical records of 60 adolescents with idiopathic scoliosis (13 males and 47 females) who were treated at The London Orthotic Consultancy in Kingston, UK. The average age of the patients was 12.4 years, and their average standing height was 156.6 cm. The data were collected between January and October 2022. During the brace fitting appointment, each patient’s height was measured immediately before and after putting on the brace. X-rays were also taken to measure how much the spinal curve improved while wearing the brace. On average, patients became about 1.24 cm taller when the brace was first fitted, although the change ranged from a decrease of 0.2 cm to an increase of 3.5 cm. The average spinal curve improved from 38° before bracing to 10° while wearing the brace, corresponding to an average absolute correction of 28° and an average percentage correction of 74%. In general, larger increases in height were associated with greater straightening of the spine seen on X-rays. These findings suggest that measuring height during a brace fitting appointment may provide clinicians with a quick, safe, and radiation-free way to gain early insight into how well a brace is working. Although height measurement cannot replace X-rays, it may help clinicians make better decisions during brace fitting and potentially reduce unnecessary radiation exposure for young patients with scoliosis. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/46645/35062 How To Cite: Courtney A, Walmsley S, Bishop T, Bernard J, Darren L, Jones R.K, et al. Immediate height gain during scoliosis brace fitting as a predictor of in-brace skeletal correction: A non-radiographic clinical indicator. Can Prosthet Orthot J. 2026;9(2):3. https://doi.org/10.33137/cpoj.v9i2.46645 Corresponding Author: Anna Courtney, Affiliation: The London Orthotic Consultancy, Kingston upon Thames, United Kingdom.E-Mails: [email protected] ID: https://orcid.org/0009-0009-0726-1186

Source: Canadian Prosthetics & Orthotics Journal

DOI: 10.33137/cpoj.v9i2.46645