In Adolescent Idiopathic Scoliosis (AIS) there is typically a three-dimensional deformity in which the spine deviates from the normal sagittal and coronal positions when standing upright, with the potential to develop into a fixed and unbalanced posture [
1,
2]. The aetiology is poorly understood, with AIS usually presenting in an otherwise healthy child [
3]. Frequency is similar in boys and girls, however progression is more common and also more severe in girls. Bracing may be used to stabilise the condition if curves progress to 25 degrees and beyond [
4]. The primary aims of conservative management of AIS are prevention of progression, improvement of pulmonary function, and treatment of pain [
2,
4].
High correction bracing has been shown to have favourable outcomes when the patient is compliant [
5,
6]. However, bracing is considered to be a traumatic experience which may leave lasting emotional scars [
7‐
9]. Since AIS affects body configuration and is a condition that will impact on an adolescent over a number of years, it has the potential to adversely affect lifestyle and behaviour. The condition may itself precipitate social problems, with brace treatment further affecting self- and body image, interactions with others, overall quality of life (QOL), and generally being a stressful experience for patients [
10‐
12]. Furthermore, wearing of the brace may be painful, and the brace may result in pressure areas [
9]. As stated by Climent and Sanchez [
13], clinical variables that may affect QOL include severity of the condition, skeletal maturity (Risser Sign), duration of brace treatment and degree of correction (conservative and/or surgical). However, the extent to which all these factors influence a particular patient's ability to benefit from the brace will depend on his/her physical, emotional and social wellbeing. In fact, psychological issues alone have been the cause for a lack of compliance to a brace protocol [
14], and approximately 9% of girls will discontinue wearing a brace because of psychological distress [
15]. Clinicians therefore need to be aware of factors that affect social wellbeing, and how these factors relate to psychosocial functioning [
16]. This having been said, there is nevertheless considerable debate as to whether patients with scoliosis treated with braces experience a poor QOL [
10]. The Brace Questionnaire (BrQ) is a condition-specific questionnaire that has been developed, validated and translated into English by Vasiliadis et al [
10]. It is specifically designed to assess QOL in children with AIS who are treated conservatively with a brace [See Additional file
1: Brace Questionnaire]. As reported by the developers of the BrQ, patients with moderate or severe scoliosis have poorer scores than those with mild scoliosis, and the tool is sensitive to changes over time (measuring improvement or deterioration of QOL according to correction or worsening of the physical condition)[
17]. Thus the purpose of this study was to compare the QOL in patients who comply with a brace protocol with those who do not.