DALLAS — For 11-year-old Hayley Gross, a visit to the clinic at Texas Scottish Rite Hospital for Children is a welcome recess from the hot plastic brace she wears to correct a curved spine.
"It's a great day because I just get a little break from it," Hayley said. "I know that I have to wear it, and that's OK with me, because I want my back to be fine when I get older."
More than seven million American have scoliosis, a condition that causes a curved spine.
Bracing has long been believed to help straighten the spine, but health experts were never sure how long patients needed to wear braces daily to get permanent results.
Many youngsters choose only to sleep in their brace, to avoid the embarrassment or discomfort of being seen publicly in a back brace.
"We can tell them that's not enough," says orthotist Donald Katz.
Katz headed a study at Scottish Rite that determined exactly how long youngsters should wear their brace each day.
"Frankly, this is very reassuring to us that we can be reasonable in our approach," Katz said. "You can get by with basically asking a child to wear it 16 hours a day."
Katz said the spinal curve did not worsen in 83 percent of patients who wore a brace that much. "And none of those patients went to surgery," he added.
The study, printed in The Journal of Bone and Joint Surgery, also found the spine's curve worsened in 70 percent of patients who wore their braces less than seven hours a day.
Donald Katz says he fitted braces with a heat sensor to make sure youngsters were wearing them as they claimed. He found patients — and their parents — often over estimated the amount of time they think the brace is being worn.
Scoliosis patients unsuccessful with bracing must often undergo surgery. But Katz says using the recommended protocol could help many patients avoid a painful and expensive operation.
"The thought of having her back opened up to a put a rod in it that's permanent, that doesn't come out, that's a pretty frightening thought," says Tracy Gross, Hayley's mother. She's making sure her daughter wears the brace at least 12 hours a day.
"The ultimate goal is to avoid surgery," she said.
The Gross family is grateful that two years into bracing therapy, Hayley's spine is far straighter.
She hopes to be walking tall — forever.