Shriners Children's Enhances Scoliosis Care with Brace Compliance Program: Tracking Technology Boosts Patient Outcomes

The Brace Compliance Program was designed by Shriners Children’s to improve patient care and health outcomes of individuals diagnosed with idiopathic scoliosis through the objective measurement of thoracic lumbar sacral orthosis (TLSO) brace wear times.

Idiopathic scoliosis is a type of scoliosis that causes the spine to develop an abnormal curve. Idiopathic means the cause is unknown, and typically appears after age 10. In many cases, idiopathic scoliosis is a small curve and doesn't require treatment, but will be closely monitored as the patient grows.

“The use of a well-fitted TLSO is a mainstay in the treatment we provide to prevent progression,” said Keith Gettys, M.D., Shriners Children’s Greenville. “It is important that our patients understand what is at stake. Without proper use, more aggressive treatment may become necessary.”

A TLSO brace is used to limit motion in the thoracic, lumbar and sacral regions of the spine, and to treat stable fractures or after surgery to the thoracic (middle) and/or lumbar (lower) parts of the spine.

Initial Research

Under the leadership of then Chief of Staff Henry Iwinski, M.D., who now serves as the chief medical quality officer for the Shriners Children’s Physicians Group, Shriners Children's Lexington launched the system’s first brace compliance program in 2018 as a research project.

Positive results and overwhelming support by the physicians led to the program being adopted clinically a few years later and growing to 736 total patients who have participated. Currently, more than 400 active patients are part of the Brace Compliance Program in Lexington.

“Compliance monitors allow us to quantify how much a child is actually wearing the brace and determine if our treatment is being effective,” said Vincent Prusick, M.D. “It provides useful reports for families to have better insight into how well their child is doing or identify areas where they can improve. Additionally, it is a helpful data set for research to analyze the effects of bracing compliance on outcomes.”