Psychological Impact of Brace Treatment on Adolescents with Idiopathic Scoliosis: A Narrative Review

Although bracing is a valuable tool in the conservative management of adolescent idiopathic scoliosis, this approach often requires the brace be worn for a minimum of 18 hours per day. Children and adolescents are the recipients of these requisites, and the impact that such demands may have on psychological functioning and quality of life is often overlooked. This narrative review summarizes the potential drawbacks of an otherwise effective and conservative approach to treatment. The results of this analysis show that quality of life in adolescents with AIS is not only influenced by pain, but also by social interaction and aesthetic appraisal. Poor body image and low self-esteem are likely risk factors in the development of mental health disorders, particularly among adolescent females. Evidence suggests that many adolescents with AIS have unmet mental health needs, with few reporting an opportunity to discuss their emotional concerns with a healthcare provider, despite many having the desire to do so. Adolescence is a vulnerable time during which many children lack the resilience to ward off the potentially lasting consequences of adverse life events. The incorporation of psychological screening and intervention into treatment protocols as well as strategies that address the aesthetics of brace wear may improve the clinical outcomes of patients with AIS.