For more than a decade, a University of Iowa Health Care orthopedics team has been chipping away at a constellation of research efforts emanating from its multicenter clinical trial “Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST).”

The landmark study, published in the New England Journal of Medicine in 2013, offered the clearest evidence to date that wearing a back brace could slow scoliosis progression and prevent spinal surgery.

Since then, the UI team, led by scoliosis expert Stuart L. Weinstein, MD, professor in the UI Department of Orthopedics and Rehabilitation, has endeavored to develop a body of research based on the results of the National Institutes of Health-funded trial, which included data from more than 300 patients at two dozen institutions.

“We’re trying to use these data in as many ways as possible,” says Lori A. Dolan, PhD, a research scientist in the Department of Orthopedics and Rehabilitation.

In May, the team took one of the top awards at SOSORT (the Society on Scoliosis Orthopaedic and Rehabilitation Treatment) annual meeting in Spain for its abstract using data from the BrAIST two-year follow-up study. The project confirmed the validity of the team’s assumption that the radiographic endpoints used in the original study were accurate predictors of the future occurrence of surgery. 

That finding supported the creation of the BrAIST-Calc,  an online tool that lets patients with adolescent idiopathic scoliosis estimate their risk of scoliosis surgery with and without bracing. When patients input age, height, weight, maximum Cobb angle, and Risser grade, the tool calculates the risk of their curve worsening without treatment. An additional click launches an individualized interactive graph where patients can experiment with how amounts of daily bracing treatment could impact their likelihood of eventual surgery.

“It’s one-stop shopping for parents and patients,” Dolan says. “The risk reduction associated with wearing a brace will pop out in a usable form.”