The Boston brace, a type of thoraco-lumbo-sacral-orthosis (TLSO),[1] is a back brace used primarily for the treatment of idiopathic scoliosis in children.[2] It was developed in 1972 by M.E "Bill" Miller and John Hall at the Boston Children's Hospital in Boston, Massachusetts.[2]
Since it lacks the metal superstructure of the Milwaukee brace, which was the most commonly worn brace until the development of the Boston brace,[3] the brace is typically not noticeable under clothing. The Boston brace is prescribed for correcting curves in the lumbar or thoraco-lumbar part of the spine. It is designed to keep the lumbar area of the body in a flexed position by pushing the abdomen in and flattening the posterior lumbar contour.[citation needed] Pads are placed at the apex of the curves to provide pressure, and areas of relief from pressure are positioned opposite the curves.[citation needed]
The brace is normally used with growing adolescents to hold a 20° to 45° advancing curve.[1][4] The brace is made of high density polypropylene lined with polyethylene foam[4] that is customized to the individual patient, and it opens in the back via a series of Velcro straps.
Daily use of the brace ranges from 16 to 23 hours a day.[5] The brace is intended to minimize the progression to an acceptable level, not to correct the curvature.[6] If the curvature continues despite the brace, then the wearer may have to undergo spinal fusion surgery.[citation needed]
M.E. "Bill" Miller patented the Boston brace in 1975.[7]