Scoliosis Specialists

The revolutionary SpineCor system for scoliosis will soon become the primary conservative management for scoliosis in the Carribean. Dr. Charles Isadore of Castries, St. Lucia will be offering the system at his clinic. Dr. Tom Pappas of Scoliosis Specialists will be in St. Lucia training providers on the SpineCor brace and protocol.

SpineCor Scoliosis Brace is the first and only truly dynamic brace, which provides a progressive correction of Idiopathic Scoliosis. Traditional rigid braces are non-dynamic and create muscle atrophy.

Dr. Pappas has been working with scoliosis for over 15 years and training providers on scoliosis management for over 5 years, and is considered one of the most knowledgeable sources on conservative management of scoliosis. Along with bracing, specific exercises will be discussed.

Recent research has shown that bracing with a dynamic brace along with SpineCor exercises can reduce a curve degree. The SpineCor Physiotherapy Program has been designed to complement the action of the brace and reinforce the principles of the treatment. Precise exercises have been designed for each type of scoliosis curve, according to the specific spine deformation and postural disorganization of the patient.

To take advantage of this opportunity and to schedule an appointment, please call Dr. Isadore’s office at (758) 572-6000. Please note that appointment time is very limited. Dr. Isadore will be seeing scoliosis patients with Dr. Pappas from March 25th - 27th.

Post-treatment results (Euro Spine 2004)

At 2 years follow-up there was an overall correction of greater than 5° for 55% of the patients, 38% had a stabilization and 7% had worsened by more than 5°. This initial cohort of patients demonstrated a general trend of initial decrease in spinal curvature in brace, followed by a correction and/or stabilization at the end of treatment, which was maintained through 1, and 2 years’ follow-up.

SpineCor is the first dynamic flexible brace for the treatment of idiopathic scoliosis. Scoliosis specialists are the largest certified providers of SpineCor in the United States for both adults and children with scoliosis.

SpineCor is a new breakthrough treatment for idiopathic scoliosis utilizing a dynamic corrective brace (DCB), clinical assistant diagnostic software (SAS) and postural measurement equipment (Freepoint). In worldwide clinical use, this new treatment has been shown to be effective in 89% of cases (either by stabilization or improvement in (Cobb) angle of the curve).

The SpineCor treatment approach is completely different to that of traditional 3-point pressure rigid braces; it is the first and only true dynamic bracing system for idiopathic scoliosis. SpineCor 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.

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.

The SpineCor bracing method is an adjustable, non-invasive technique that provides flexible, inconspicuous correction that continues as a child moves and grows.  The goal of the dynamic brace is to maintain and improve spinal deformity while re-educating the body to return to a more normal posture.

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