For more than 50 years, orthopedic surgeons at Boston Children’s Hospital and elsewhere have prescribed rigid back braces for some kids with scoliosis. In theory, bracing prevents worsening of the curvature and might allow the child to avoid surgery to correct the curve. But the treatment can be challenging. Subjecting a child to a bulky back brace during the emotionally vulnerable teen years is not high on any parent’s or physician’s wish list. Plus, until last week’s study published in New England Journal of Medicine, some physicians weren’t sure if bracing was effective.
“Although Boston Children’s Orthopedic Center always believed bracing worked and recommended it for appropriate patients, we wanted to have robust controlled data that prove or disprove that bracing is worth the efforts of the family and adolescent, as well as being cost efficient to the health care system,” says Daniel Hedequist, MD, orthopedic surgeon. In 2007, Hedequist and the Boston Children’s orthopedic center team joined the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) to help answer questions about the effectiveness of bracing.
For most children with scoliosis, the path to recovery is marked by simple observation and bracing. But when one patient battles two curves, her path—and spine—take an unexpected turn.
At 11 years old, it wasn’t normal for Anjellina Guiliano to have back pain. At first, she thought she might have slept on it awkwardly, and shrugged it off. When it continued to hurt for weeks, her mother, Francine, began to rub her daughter’s back with a topical pain reliever each night to make the pain go away.
But as Anjellina took her zombie costume off after trick-or-treating on Halloween, Francine noticed something that she hadn’t seen before: two large bumps—one under her right shoulder and one near her left hip. “I noticed it right away and my eyes filled up instantly,” says Francine. “When I had been rubbing her back, she had always been sitting, but standing up, it looked like she was hiding mini watermelons under her skin.” Panicked, she made a doctor’s appointment for the next day.
At Anjellina’s primary care doctor’s office, it was clear that Anjellina needed specialized care. “I heard the doctor yell to the receptionist, ‘Get Children’s on the phone,’ and it really scared me,” says Francine. …