Scoliosis Specialists

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.

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.