Influence of the Wilmington brace on spinal decompensation in adolescent idiopathic scoliosis

The Wilmington brace is a custom-molded thoracolumbosacral orthosis for decompensated adolescent idiopathic curves. Using the roentgenographic measurement of Rudicel and Renshaw, 71 patients with pretreatment curves that were decompensated greater than 1.0 cm were investigated in detail. The average follow-up period was two years. There was no correlation between pretreatment Cobb angle and the magnitude of spinal decompensation. Pretreatment decompensation averaged 1.9 cm for 22 thoracic curves, 2.5 cm for 32 thoracolumbar-lumbar curves, and 2.4 cm for 17 double-structural curves. Overall, decompensation was improved in 50 patients (70%). Improvement in spinal decompensation averaged 1.4 cm for thoracic, 1.4 cm for thoracolumbar-lumbar, and 1.5 cm for double-structural curves, with decompensation in 27 patients (38%) measuring less than 1.0 cm at follow-up evaluation. An increase in spinal decompensation, averaging 1.2 cm, was found in 6% (one thoracic, two thoracolumbar-lumbar, and one double-structural curve). Spinal compensation is favorably influenced in the majority of patients treated with Wilmington brace for adolescent idiopathic scoliosis.