The patient was fitted with the TLSO one month after the initial consultation. Postural photographs taken at the time of the brace fitting revealed notable postural improvements in the sagittal and coronal planes (Figure 3).
Plain films demonstrated that there was no significant change in the magnitude of the curve in-brace, however the patient’s coronal balance was significantly improved with the patient’s posture being more aligned with the central sacral vertical line through C7 and S2 (Figure 4).
One month after the brace fitting the patient reported that they had been wearing the brace each day since the fitting. The patient stated that she had experienced some mild constipation in the early stages of brace-wear, but this had passed, and she felt more stable in the brace. She had also noticed that her posture was improved.
The patient was advised to be more active in the brace to build strength and endurance in the muscles that support the spine whilst being held (by the brace) in a more normal postural alignment. This was further reinforced by having the patient perform scoliosis specific exercises at home each day. The focus of these sessions was to teach the patient how to actively place their body in correct spinal alignment through muscular contraction.
In addition to these active self-correction exercises, the patient was also given floor exercises to promote activation of the muscles involved with trunk stabilisation.
The patient is still under care, however at the most recent follow-up appointment (14 months of treatment) the patient stated that she was wearing the brace for 7 hours each day and completing the exercises regularly throughout the week. The patient reported that the brace was helpful most of the time. The exercises did cause cramping on occasion but seemed to be having a positive effect.
Postural photos taken at the most recent follow-up appointment demonstrate a stabilisation of the patient’s postural changes in the coronal and sagittal planes (Figure 5 & 6). The patient’s scores on the SRS-22r have remained relatively stable with clinically significant improvements noted in the ‘function’ domain. The patient has been advised to continue with the part-time bracing and exercise program to maintain the improvements that have been achieved thus far.