Scoliosis Specialists

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.

Scoliosis is a disorder in which there is a sideways curve of the spine, or backbone. Curves are often S-shaped or C-shaped. In most people, there is no known cause for this curve. This is known as idiopathic  scoliosis. 80% 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 orthopedic rigid brace, and the second one is surgery with a spinal system.

Despite some effectiveness, currently available braces, because of their rigidity, are damaging to a certain degree to the normal development of the neuro-musculo-skeletal system .

• Bone structures, especially the rib cage, have to stand significant mechanical constraints that can lead to some malformation and atrophy of mobile structures.

• Muscles are barely active and can only be maintained through a heavy physiotherapeutic treatment.

• Because of the pseudo-atrophy of the spine’s muscular system, it is not possible to guarantee that the correction obtained by the brace will be permanent.

• Finally the aesthetical results are generally poorly acceptable. In most cases, the adolescent prefers the cosmetic results following surgery in spite of the scars.

In order to have better results in idiopathic scoliosis, early treatment while reducing or eliminating any drawbacks as well as using the neuro-muscular corrective potential, we have developed a new therapeutic tool based on an innovative approach. SpineCor the Dynamic Corrective Brace is the first and non-rigid brace which aimed at correcting scoliotic deformation through self-maintained correction of the neuro-musculo-skeletal system. SpineCor full potential is achieved with skeletally immature pre-adolescents with progressive idiopathic scoliosis of less than 30°.

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 up to the limit imposed by the pre-existing bone deformation.

• Neuro-muscular stimulation and correction.

The design of SpineCor happened through a scientific process based on decades of knowledge on scoliosis and its treatment. Therefore, we can be optimistic about its efficiency.

Abstracts (Confidence Interval (CI): 1.00 to 1.00) for G1,  p¼ 1.00 (CI: 1.00 to 1.00) for G2; Year 2: (p) ¼ 0.98 (CI: 0.93 to 1.00) for G1,  p¼ 0.92 (CI: 0.82 to 1.00) for G2; Year 3: p ¼0.92 (CI: 0.83 to 1.00) for G1, p¼ 0.92 (CI: 0.83 to 1.00) for G2; Year 4:  p¼ 0.88 (CI: 0.76 to 0.99) for G1, p ¼ 0.92 (CI: 0.73 to 1.00) for G2.

A 30-SECOND ANNUAL POSTURAL SCREENING BETWEEN THE AGES OF 10 AND 15 CAN MAKE A LIFETIME OF DIFFERENCE:

Normal (fig. 1)

• head centred over mid-buttocks

• shoulders level

• shoulder blades level, with equal prominence

• hips level and symmetrical

• equal distance between arms and body

Possible Scoliosis (fig. 2)

• head alignment to one side of mid buttocks

• one shoulder higher

• one shoulder blade higher with possible prominence

• one hip more prominent than the other

• unequal distance between arms and body

Normal (fig. 3)

• both sides of upper and lower back symmetrical
• hips level and symmetrical

Possible Scoliosis (fig. 4)

• one side of rib cage and/or the lower back showing uneven symmetry

Normal (fig. 5)

• even and symmetrical on both sides of the upper and lower back

Possible Scoliosis (fig. 6)

• unequal symmetry of the upper back, lower back or both

When the deformity is minimal, treatment is not normally indicated, medical observation is sufficient.

However, if the deformity progresses and becomes severe enough, there are two types of treatment possible :

• Brace (non-surgical)
• Surgery

The SpineCor system is a flexible brace that is principally prescribed for Idiopathic Scoliosis patients with a Cobb angle between 15° and 50° and Risser sign 0 to 3.  The brace is fitted on the patient in accordance to a sub-classification of the traditional SRS definition of curve types.  The SpineCor Assistant Software guides the treatment provider through the fitting process.  The brace is prescribed to be worn by the patients 20 out of 24 hours per day until they have reached maturity, with radiological evaluations performed prior to and immediately following the fitting of the brace, and every 4 to 6 months afterwards.  To accommodate for growth and postural changes, corrective bands need to be adjusted frequently and require replacement each 6-12 months for optimum brace performance.

Still, today, 80% 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.

In both cases, the therapeutic benefits can unfortunately be associated with non-negligible drawbacks that limit their uses.  Because of a better understanding of the risk associated and of the disease evolution, we have seen a shift towards earlier treatment.

The correlation between growth potential of the child, and, more specifically, of the adolescent, and the evolution of the scoliosis has been clearly established. It was demonstrated by Duval-Beaupère  and many others ^[inc. . This means that the earlier the scoliosis appears, the greater the risks of evolution. Lonstein & Carlson analysed the natural evolution of scoliosis in a population of 729 adolescents. They concluded that a child with an angle between 20° and 29° and a Risser of 0,1 or 2, will see his/her scoliosis evolve in 68% of the cases. Stagnara and Clarisse and other authors have named the 30° limit “the critical limit” because, beyond this point, during high velocity growth periods, evolution of the disease is guaranteed.

Title:
Effectiveness of the SpineCor brace based on the new standardized criteria proposed by the S.R.S. for adolescent idiopathic scoliosis
Published:
Journal of Pediatric Orthopaedics, June 2007, P. 375-379
Authors:
Coillard C
Vachon V
Circo C
Beauséjour M
Rivard CH

JPOS Spinal Core Paper.pdf

Title:
Survival analysis of a group of 365 idiopathic scoliosis patients treated with the Dynamic SpineCor Brace
Published:
Résonances Eurospéenes Du Rachis. 14(43):p. 1782-1786. French.
Authors:
Vachon V
Coillard C
Zabjek KF
Rhalmi S
Rivard CH

Survival-Analysis2006.pdf

Title:
Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management
Published:
Spine, v. 30, no. 18, p. 2068-2075.
Authors:
Richards BS
Bernstein RM
D’Amato CR
Thompson GH

Richardsetal2005.pdf