# Bracing and non-surgical management of scoliosis in Canada: Early detection, access inequities, and the need for interdisciplinary reform

## TL;DR

This paper discusses challenges in managing scoliosis in Canada, emphasizing the need for early detection and better non-surgical treatment access.

## Contribution

The paper highlights systemic barriers to early scoliosis detection and advocates for a national strategy to improve non-surgical care.

## Key findings

- Many Canadian patients present with scoliosis too severe for bracing, leading to unnecessary surgeries.
- Non-surgical treatment is underfunded compared to high-cost surgeries in Canada.
- A coordinated national strategy is needed to improve screening and treatment access.

## Abstract

Bracing remains the cornerstone of non-surgical management for adolescent idiopathic scoliosis (AIS) with an aim to minimize the risk of progression and to avoid spine surgery. In Canada however, one third to half of patients present with curve magnitudes too severe for optimal brace treatment, resulting in higher than necessary surgical volumes. High-cost spine surgeries are fully funded while non-surgical management is not. This Professional Opinion article highlights systemic barriers to early detection that limit opportunity for non-surgical management in Canada and ultimately drive up healthcare spending. In Canada, there is an urgent need for a coordinated national strategy to re-establish routine scoliosis screening, ensure equitable public funding for treatment and expand professional training in non-surgical spinal care.