Do not postpone time-sensitive treatment until after examinations
A scoliosis brace is a rigid support used while a child's skeleton is still growing. In a randomized comparison, 75% of braced adolescents avoided progression to the study's surgical threshold, compared with 42% under observation. The treatment window follows skeletal growth, not the school examination calendar. Ask the specialist what a delay would mean for this child.
What it takes
The decision to act promptly costs nothing in itself; treatment and follow-up have their own costs and take time away from school. Scoliosis bracing may require at least 18 hours a day and substantial persistence.
What you may gain
A multicenter study enrolled 242 adolescents with idiopathic scoliosis who met bracing criteria: 116 were randomized and 126 chose treatment. Failure was progression to a curve of at least 50 degrees; success was reaching skeletal maturity without that progression. In the randomized intention-to-treat analysis, success was 75% with bracing versus 42% with observation, OR 4.11, 95% CI 1.85–9.16. This is about four times the odds of success, not four times the probability. Combining randomized and preference groups gave 72% versus 48%, adjusted OR 1.93, 1.08–3.46. More daily hours of brace wear were associated with greater success, P<0.001. The trial stopped early because of demonstrated benefit.
Context & considerations
Scoliosis is the example because it has randomized evidence, a clear growth-related window, and is a school screening priority; see entry 7. Other conditions with potentially important timing include strabismus, amblyopia, dental decay, and planned surgery for congenital heart disease. Their individual windows and consequences of delay differ, so ask the relevant specialist. China's school-leave system can preserve enrollment for a period of treatment, with each application lasting up to one year; see entry 11.
Research & references
Weinstein SL et al. (2013). Effects of bracing in adolescents with idiopathic scoliosis. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1307337