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).

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.

]]> http://scoliosisspecialists.com/blog/?feed=rss2&p=190 http://scoliosisspecialists.com/blog/?p=186 http://scoliosisspecialists.com/blog/?p=186#comments Wed, 08 Sep 2010 13:53:50 +0000 scoliosis specialists http://scoliosisspecialists.com/blog/?p=186 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.

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 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.