By Dr. A. Josh Woggon........

There are no definitive answers to this question to be found (most likely due to the wide variance in the types of scoliosis braces used, and the lack of a formalized data collection practice amongst the various scoliosis brace companies).

However, The Burden of Musculoskeletal Disorders provides information that may help to come up with a reasonable estimate. As stated in Chapter 3:

ďIn 2004, an estimated 1.26 million patients utilized health care resources for care of problems associated with a spinal deformity. The majority (74%) of these care episodes were with a physician, and involved non-surgical and pre-surgical management of this complex patient population.Ē It is also stated that: ďThe overall prevalence of spinal deformity in the total populations is projected to be much higher than current data implies.Ē

Approximately 134,500 persons were hospitalized with a diagnosis of spinal deformity; nearly all (93%) of these were diagnosed with idiopathic scoliosis (so 125,085 people were hospitalized for scoliosis in 2004). One in three persons hospitalized with a diagnosis of scoliosis underwent surgery; this means 41,695 scoliosis surgery procedures were performed in 2004.

In total, 511,155 diagnoses of scoliosis were made in 2004; 153,578 males, and 367,577 females. This represents 55% of the total number of spinal deformity diagnoses (Scheuermannís kyphosis, etc).Ē

So, if 74% of 1.26 million visits made for spinal deformities were with a physician, and if 93% of patients with spinal deformities have scoliosis, that means roughly 867,132 visits to physicians were made by people with scoliosis. If the total number of diagnoses were 511,155, it is reasonable to assume that 355,957 visits were repeat visits made by people diagnosed previously.

60% of 511,155 diagnoses were patients under 18; this equals 306,693. Only children under 18 are eligible for scoliosis bracing. Because back bracing requires repeat visits, if we take 60% of 355,957, we get the maximum number of cases that could have been braced in 2004: 213,574.

So if 306,693 children were eligible for orthopedic bracing in 2004, how many decided to undergo bracing? This is where it gets tricky.

As I stated earlier, the maximum number of cases of scoliosis patients under 18 that could have been braced was 213,574; this would mean 69.6%, or roughly two out of three cases, chose to undergo bracing. This seems unreasonable; I seriously doubt two out of three people would choose to undergo bracing.

Returning to the earlier data about surgery, if only one in three patients who were hospitalized underwent surgery, perhaps the other two were admitted to the hospital for bracing procedures? Itís unclear from the data if this is the case, but itís a reasonable place to start. So of the 125,085 people hospitalized for scoliosis, if 2/3rds were braced, that would mean roughly 83,390 cases of scoliosis were treated with a brace in 2004.

306,693 children were eligible for bracing; if 83,390 were braced, that would mean 27.2%, or roughly one-in-four, decided to undergo bracing. This sounds reasonable to me.

However, itís important to note that this data is only looking at hospital visits; braces applied by private practices would not be included. So 83,000 seems like a low estimate, but again, a reasonable one.

Hope this is helpful; the data isnít strong enough to draw conclusions from, but itís a place to start. Iíll let you know if I find any higher quality evidence.

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