Scoliosis Specialists

The Dynamic SpineCor orthosis, developed in 1992-93, uses a specific Corrective Movement  which is dependant of the type of the curve. Curve classification was based on the classification of Leroux and Coillard. For the treatment, the curve specific Corrective Movement  is performed and the orthosis is applied according to definitions contained in the SpineCor Assistant Software.

All the health providers need to complete a two-phase training course before fitting the SpineCor orthosis. The first phase involves reviewing of all information necessary to understand the “Corrective Movement Principle”, the specific classifications and a workshop to fit the orthosis following these different corrective movements. The second phase consists of fitting the brace at their own practice of at least three or four patients with the help of a recognized trainer.

In order to be effective and to obtain a neuromuscular integration the orthosis must maintain and amplify the corrective movement over time. Additionally, the orthosis must be worn 20 hours a day for a minimum of 18 months to create a neuromuscular integration of the Corrective Movement  through active bio feedback.  Generally, the orthosis is stopped at skeletal maturity (at least Risser 4).

Adult scoliosis management differs from adolescent treatments due to the long standing nature of the problem. This leads to dysfunction of the motion segments in the spine and degeneration in the ligaments, which perpetuates the arthritic changes that may occur. Although not the goal, adults can achieve curvature reduction despite reaching maximal bone maturity. Adult patients can also respond well with a program that may include postural retraining, strengthening exercises, and chiropractic care.

Scoliosis in adults is typically the result of either having the disease as a child which has progressed to adulthood, or from the degenerative processes of abnormal aging. The scoliosis can be of any classification ( lumbar, thoracic, thoracolumbar, etc) and can result in chronic pain, leg discomfort, digestive, and lung complications.

Options for adults with scoliosis are somewhat limited. Bracing is a good way to manage scoliosis in an adult who has moderate to severe problems. Along with specific therapy and exercise the brace will offer the adult support, and increased opportunity to halt progression of the curve. It must be stated that adult scoliosis is rarely reversible. The goal through adult bracing is instead to decrease chronic pain and allow a way for the adult to regain a comfortable lifestyle.

The Department of Paediatric Orthopaedics and Traumatology at Pomeranian Medical University did a study of SpineCor dynamic Bracing for idiopathic Scoliosis. Orthopaedic bracing is used in conservative treatment of spinal curvatures. Apart from rigid braces, SpineCor dynamic braces with a flexible design have recently become available. The idea behind dynamic bracing is that derotational and correcting forces are transmitted via a system of corrective bands. The essence of this technique is maintenance of spine mobility while effecting a position in which all components of the three-plane deformity are corrected. The aim of this study is to evaluate early outcomes of SpineCor dynamic brace treatment for idiopathic scoliosis according to SRS methodology and criteria.

The study group included 50 patients who were using SpineCor braces due to idiopathic scoliosis. The indication for bracing was the finding of a >15(5) spinal curvature in skeletally immature patients (Risser grade 0-3). Correction or stabilization of the scoliosis (Cobb angle change of +/- 5 degrees ) were recognised as positive outcomes, while a negative outcome was defined as progression of the curve of more than 5 degrees or to a value necessitating operative treatment. The study group was divided into subgroups at enrollment, according to gender and degree of scoliosis.

In the entire study group, correction was demonstrated in 24 patients (48%), stabilization in 14 (28%) and progression in spite of bracing occurred in 7 patients (14%). Five patients in the entire study group (10%) required operative treatment due to rapid curvature progression.  SpineCor bracing led to stabilization of scoliosis in the majority of the patients. Introducing the SpineCor brace in patients with a scoliosis angle over 20 degrees and Risser grade 0-3 very effectively prevented curve progression.

Scoliosis is a an abnormal lateral curve to the vertebral column.  The degree of scoliosis can range from mild to severe. Scoliosis is most commonly an incidental and harmless finding. Patients with milder curves may only need to visit their doctor for periodic observation. Scoliosis may be congenital (a birth defect) or acquired (degenerative, arthritic, or traumatic).

Majority of the scoliosis cases are known as idiopathic. Since the true cause is unknown, the treatment can only be based on the symptoms. Until now, only two types of treatment have been known to be efficient: the first is the treatment using an orthopaedic rigid brace and the second one is surgery with a spinal system. Unfortunately only a few treatments have actually been shown to affect the outcome of scoliosis.

The treatment options of scoliosis depend on the severity and the age of the person.  Scoliosis bracing has been shown to be an effective method to prevent curves from getting worse. Until recently, this treatment was reserved for children and adolescents in whom the prediction of a rapid increase in the curve needs to be thwarted.  Today, there is spinecor, a revolutionary new soft flexible scoliosis brace that has changed the way we look at scoliosis treatment both in kids and adults.

SpineCor changes the dynamic of the trunk while harmonizing the posture. It is a therapeutic means with less mechanical constraints and an acceptable comfort level that preserves and enhances movements with a double therapeutic action:   Progressive correction of the spine deformation and Neuro-muscular stimulation and correction.

SpineCor  treatment was developed in the early 1990s and utilises a Dynamic Corrective Brace (DCB), together with a completely new treatment approach requiring clinical assistant diagnostic software (SAS) to allow accurate fitting and treatment follow up.

Following 12 years of clinical research and trials, SpineCor is now rapidly being made available to patients around the world and by the leading provider http://www.scoliosisspecialists.com/ in the USA.  The initial excellent clinical results produced by the research centre at Ste Justine Hospital and the University of Montreal, Canada, have since been replicated by more than 80 other treatment centres around the world. SpineCor has shown to be effective in 89% of cases (either by stablisation or improvement in (Cobb) angle of the curve).

SpineCor’s unique treatment approach offers improvement over traditional braces, which are essentially static or allow minimal movement, due to its true totally dynamic action. Fundamental research by independent research groups now indicates that a significant dynamic action is required on the spine (vertebral growth plates) to alter the abnormal growth progressing the deformity in scoliosis patients.

The SpineCor treatment approach is completely different to that of traditional braces that use 3-point pressure and distraction; it is the first and only true dynamic bracing system for idiopathic scoliosis. SpineCor’s unique approach to treatment by global postural re-education has been shown to give progressive correction over time which, unlike any previous brace treatment, is extremely stable post brace weaning.

1.       Overcorrecting the posture, to encourage strengthening of weak muscles and ligaments, and intervening at a proprioceptive (brain level) to encourage normalization of posture.

2.       Changing the forces on the bony parts of the spine (vertebrae) to encourage catch up growth in children who still have immature and growing spines.

The objective of this study was to quantify the relationship between gibbosity and spinal deformation expressed by the angle of Cobb before and during treatment with a brace for different classes of idiopathic scoliosis patients. As part of the standard treatment with the Dynamic Corrective Brace (SpineCor), 89 idiopathic scoliosis patients underwent an initial radiological examination and gibbosity measurement with a scoliometer wearing and not wearing the brace.

The 89 patients were classified in relation to the apex of the scoliosis curves: thoracic (n = 29); thoracolumbar (n = 40); lumbar (n = 7) and double (n = 13). With the dynamic corrective brace, the patients showed a mean decrease of 8.3° for the major Cobb angle, and a mean decrease of 2.3° for their gibbosity. There was a significant positive relationship between gibbosity and Cobb angle with and without the brace for the thoracic and thoracolumbar curves. A linear regression analysis identified a small mean estimation error for the thoracic curves (7.4° no-brace; 2.7° with brace) and thoracolumbar curves (5.2° no-brace; 5.3° with brace), indicating a predictive potential of the scoliometer. The measure of gibbosity with the scoliometer provides a fairly reliable estimation of Cobb angle at the initial clinical examination of a scoliosis patient. However, when initial Cobb angle and gibbosity are considered, the measure of gibbosity when wearinga brace provides the clinician with a highly reliable estimation of the Cobb angle while in a brace. This relationship also exists for the follow-up with a brace, permitting a judgement of the patient’s evolution under the treatment with SpineCor.

After the diagnosis of idiopathic scoliosis using clinical and radiological evaluations, the measure of gibbosity with the scoliometer provides only a fairly reliable estimation of Cobb angle prior to the treatment. A similar relationship also exists during the follow-up with the SpineCor brace. The gibbosity cannot be utilised as the only criterion by which to judge the prognosis of idiopathic scoliosis. However, when the measure of gibbosity in the brace is used in combination with the initial Cobb angle and gibbosity, it is possible to limit the necessity of a radiograph at each visit. In this situation, the gibbosity provides more information regarding the thoracic than the thoracolumbar region.

The most common of all types of scoliosis is adolescent idiopathic and is seen with equal frequency in boys and girls at low curve magnitudes. Girls, for unknown reasons, have a significantly higher risk for development of curve progression than boys. Pulmonary and cardiac function are not impeded with lumbar curves and significant changes of pulmonary function are not seen in patients with thoracic curves until the curve reaches a level greater than 70° , i.e., a severe curve. This amount of curve and subsequent cardiac and pulmonary changes are often seen later in life in untreated idiopathic infantile and juvenile scoliosis patients and present a threat to life. Patients with adolescent onset idiopathic scoliosis do not usually have such compromise unless severe curves develop. The time of highest risk for curve progression in adolescent idiopathic scoliosis occurs around puberty, i.e., when the growth rate is the fastest.

On September 16, 1998, at an orthopedics symposium in New York City, Dr. Christine Coillard and Dr. Charles Rivard, pediatric surgeons from Sainte-Justine Hospital in Montreal, presented clinical findings on a promising, new, therapeutic approach for idiopathic scoliosis. Drs. Coillard and Rivard had long concurred that bracing was the most conservative option available for children with minor scoliosis. However, they also realized the challenges presented by a child’s growth patterns as well as his or her physical and psychological need for normal mobility. Their studies were based upon these challenges, and as a result of their research, the SpineCor bracing system evolved. Together with their team of researchers from anthropology, biomechanics, and physiotherapy they seek to minimize the three dimensional deformity of scoliosis by addressing what they believe to be four important aspects of the condition, deformation of the spine, postural disorganization, muscle dysfunction, and unsynchronized growth.

The benefits of the SpineCor brace are that it allows patients four hours per day out of brace, and provides total freedom of movement. The brace is more easily concealed under clothing, is more comfortable and cooler to wear, and is less restrictive. SpineCor has no side effects from muscle atrophy which may be caused by rigid bracing, and excellent treatment results, particularly when treatment is started early.