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Fortydegrees
10-02-2013, 06:43 PM
My daughter (aged 13) has a C curve at 40 degrees. The specialist said bracing will not assist her because her trunk has shifted. I haven't been able to find much information about this and would like your opinion. Is surgery required once a trunk has shifted? Does bracing stop working once this happens?

Also, the specialist said once the trunk shifts the curve continues to get worse. Could he have meant up until she stops growing, or do curves get worse through adulthood too?

Dr Scoliosis
02-03-2013, 01:44 PM
Thank you for your enquiry. Without more details it is impossible to be precise in the information I pass on to you but some comments in general terms are permissible.

With larger curves such as those which are >40 degrees, bracing is not effective because to have a corrective force a great deal of pressure has to be exerted over the apex of the curve and this is not a practical proposition. For most curves, bracing is reserved for patients who are in the active growth phase and whose curves have been shown to increase on progressive x-rays with a range of 30-40 degrees or thereabouts. It is to be emphasised that bracing plays a role in trying to keep the curve in acceptable limits through the growth phase. Bracing never completely eliminates a curve. Rather, it is a matter of curve control.

The term trunk shifting is applied when the torso and head, together with the upper limbs, are not centred over the pelvis. Most often we call this truncal imbalance or truncal decompensation. In general terms it is an unfavourable sign for progression. Curves which are out of balance may continue to increase in adult life.

I trust this information is helpful.

Dr Scoliosis