SpineCor Brace

Is physical therapy beneficial?

2008-10-24T13:25:00.002-07:00

There is at this point in time no evidence to prove scientifically that physical therapy provided in conjunction with SpineCor provides any additional benefit, however, we do advise its use in certain cases. Physical therapy does have the potential to:

Help mobilize the spine
Reinforce the corrective movement
Help with active self correction
Help consolidate the corrective movement and gain a neuromuscular integration (stabilizing the curve).
Speed up correction.

All published data on SpineCor relates to treatment using the brace alone 20 hours out of 24 following our published treatment protocols.

For more on the SpineCor Brace go to http://www.scoliosisspecialists.com/

How does SpineCor compare to other braces?

2008-10-24T13:25:00.001-07:00

SpineCor is a dynamic non-rigid brace, meaning it is flexible. This important feature leads to numerous benefits:

Preserves body movement
Promotes corrective growth whilst continuing normal activities of daily living
Can be discreetly worn beneath patient's clothing for optimum self-image
Increases patient's acceptance for the treatment leading to optimal results
Over long-term offers a cost-effective solution to patient
Proven stability of treatment results after bracing discontinued, quite unlike rigid bracing
Clinical observation shows significant postural improvements
No side effects (such as muscular atrophy).

For more on Spinecor Soft brace go to http://www.scoliosisspecialists.com

SpineCor Treatment Overview

2008-10-24T13:22:00.000-07:00

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.

The initial excellent clinical results produced by the research centre at Ste Justine Hospital and the University of Montrea, 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.

Clinical experience to date also shows better compliance & cosmetic results.

SpineCor:

Allows patients four hours per day out of brace
Allows total freedom of movement
Offers better cosmesis under clothing, and Is cooler to wear.

With all of these benefits, it is not difficult to see why compliance might be better than with bulky, rigid braces that severely restrict movement and must be worn 23 hours per day.

Although to date no specific study has been undertaken to quantify cosmetic improvement, subjectively, some striking improvements have been observed clinically. Additionally, some very positive postural changes have been noted in cases where there has been no change in Cobb angle.

Summary

SpineCor offers:

A treatment approach based on the latest understanding of the cause and progression factors of Idiopathic scoliosis.
A much more acceptable treatment to patients, being cooler to wear, less restrictive, more easily concealed under clothing and 4 hours of out of brace time per day.
No side effects. Rigid braces cause muscle atrophy and can be harmful to normal development in a growing child.
Excellent treatment results, particularly when treatment is started early.
Excellent stability of treatment results post bracing.
Neuromuscular integration for maintenance of improved posture.
Potential to reduce incidence of surgical intervention.

Conclusion

SpineCor is a highly effective for the early treatment of idiopathic scoliosis as demonstrated in the case study and also offers significant benefits to patients who present late. The real challenge is, therefore, to increase awareness of the absolute importance of early diagnosis and, that a viable treatment for early intervention is now available. Clearly it is easier to prevent progression of a small curve than to reverse the deformity in a large curve. Timing is of absolute importance - the later treatment is started the lesser the possibility there is to change the curve, as the child's growth runs out so does the possibility to make any change.

For more information on spinecor go to http://www.scoliosisspecialists.com/

Summary of the latest Clinical Results

2007-07-19T21:56:00.000-07:00

SPINECOR PATIENTS PROSPECTIVE OBSERVATIONAL COHORT

At Ste-Justine Hospital in Montreal 472 patients have been treated with the SpineCor system since 1993. For this group of consecutively treated Idiopathic Scoliosis patients the average age at the beginning of treatment was 12 years (SD: 2 years), with 438 female and 34 male subjects. The average initial major Cobb angle was 29° (SD: 8º, n = 472). The initial Risser sign was 0 for 293 patients, Risser 1 for 59 patients, Risser 2 for 59 patients, Risser 3 for 56 patients, Risser 4 for 3 patients and 2 patients had a Risser 5.

At the last available visit there were 167 patients still under treatment and 225 have terminated treatment with a post-treatment follow-up time ranging from 0 to 6 years with a mean bracing time of 2.3 years (SD: 1 year). From this cohort of 472 patients, there were 69 patients who progressed to surgery (15 %). The patients who progressed to surgery had an initial mean Cobb angle of 35° (SD: 8°). There were also 16 patients who withdrew from treatment.

-Outcome for Idiopathic Scoliosis Patients who completed treatment by the SpineCor brace

There are 225 patients who have completed treatment with the SpineCor brace with an average duration of treatment in brace of 2.3 years (SD: 1.1). The initial mean Cobb angle for this sub-cohort of patients was 28º (SD: 8º). At the weaning point, there was an overall correction in reference to the patient’s initial state of greater than 5° for 40% of the patients (mean: 11°; range: 6° to 22°), there was a stabilisation for 47% (mean: 1°; range -5° to 5° ) and 13% of the patients worsened (mean: -11°; Range: -6° to -23°. Success (correction or stabilisation of the Cobb angle) was achieved in 87% of the case.

-Outcome for Idiopathic Scoliosis Patients with a Minimum 5-year Follow-up after Treatment with the SpineCor brace

There are 45 patients who have a minimum of 5 years post-treatment follow-up with the SpineCor brace with an average duration of treatment in brace of 2.2 years (SD: 0.9). The initial mean Cobb angle for this sub-cohort of patients was 27º (SD: 8º).

Comparing the initial Cobb angle to the angle at the end of bracing, there was an overall correction of greater than 5° for 48% of the patients (mean: 11°; range: 6° to 22°), there was a stabilisation for 49% (mean: 1°; range -3° to 5°) and 4% of the patients worsened (mean: -2°; Range: -10° to -14°).

If we now compare the Cobb angle at the initial state and 5 years after the end of bracing, there was an overall correction of greater than 5° for 53% of the patients (mean: 11°; range: 6° to 26°), there was a stabilisation for 38% (mean: 2°; range -3° to 5°) and 9% of the patients worsened (mean: -7°; Range: -6° to -9°).

Finally, if we compare the Cobb angle at the end of bracing and 5 years after weaning of the brace there was an overall correction of greater than 5° for 27% of the patients (mean: 7°; range: 6° to 13°), there was a stabilisation for 66% (mean: 1°; range -5° to 5°) and 7% of the patients worsened (mean: -9°; Range: -8° to -10°).

THESE RESULTS DEMONSTRATED THAT 27% OF THIS COHORT OF PATIENTS STILL CORRECTED THEIR COBB ANGLE AFTER WEANING OF THE BRACE.

For more info. please visit http://www.scoliosisspecialist.com

Welcome to SpineCor Brace...

2007-06-04T22:15:00.001-07:00

Spinecor Scoliosis Brace Is the first and only truly dynamic brace, which provides a progressive correction of Idiopathic Scoliosis from 15º Cobb angle and above. Preserves normal body movement and growth and allows normal activities of daily living. It is worn comfortably and easily under clothing. Increases patient's treatment acceptance leading to better compliance.

Indications

The SpineCor System was designed for the treatment of Idiopathic Scoliosis only (from 15º and above). Its efficacy for treating neuromuscular, neurological or other types of scoliosis is unknown and generally non Idiopathic Scoliosis is contraindicated.

SpineCor Components

The SpineCor Dynamic Corrective Brace is made up of two sections:

The first section consists of the pelvic base (1), the crotch bands (2) and the thigh bands (3). Its role is to act as an anchoring point and support for the actions applied to the patient's trunk by the corrective elastic bands.
The second section consists of the bolero (4) and the corrective elastic bands (5). This is the part designed to make the correction of the scoliosis curve. The fitting of the corrective bands is specific for each patient and depends on the type of curve.

Spinecor Brace Components

2007-06-04T22:11:00.000-07:00

The Spinecor dynamic corrective brace is made up of two components:

The first component consists of the pelvic base, the crotch bands and the thigh bands. Its role is to act as an anchoring point and support for the actions applied to the patient’s trunk by the elastic bands. When the pelvic base is stable, the traction by the elastic bands is provided along the stable lines. The flexible nature of the pelvic section of the brace permits free movements of the trunk and engagement of the pelvis in the corrective movement.
The second component consists of the bolero and the corrective elastic bands. Its function is directly related to the active principle of the dynamic corrective brace. It allows a custom fitting of the brace aimed at modifying the postural geometry of the moving spinal column. The corrective elastic bands of different length allow for many possibilities in brace adjustment for an optimal correction. Overall, there are 4 major ways to fit the corrective bands, corresponding to the thoracic, thoracolumbar, lumbar and double scoliosis. The SpineCor Assistant Software provides the guidelines for the choice of the bands and snaps.

SpineCor Indications & Contra Indications

2007-06-04T22:07:00.000-07:00

SpineCor has been designed for the treatment of idiopathic Scoliosis only. Its efficacy for treating neuromuscular, neurological or other types of scoliosis is unknown and generally non-idiopathic scoliosis is contraindicated.

Indications:

Idiopathic Scoliosis diagnosed and confirmed.
Boy or Girl from 5 years of age +.
Initial Cobb angle equal or above 15°, proven progression of more than 5° in last 6 months or strong family history.
Initial Cobb angle equal or below 50°.
Risser 0, 1, 2, 3 or pre-menarchial.
Curve Types: All classes including curves that are inverse to normal patterns (e.g. Left Thoracic, Right Lumbar)

Contra Indications:

Scoliosis resulting from a deficit of the neuromuscular system
Traumatic paraplegia or quadriplegia
Spinal Muscular Atrophy
Friedreich's Ataxia
Familial Dysautonomia
Peroneal Muscular Atrophy
Duchenne
Myopathy

Postural Scoliosis: when a supine X-ray compares with a frontal X-ray shows an almost complete reduction (Cobb angle less than 5°).

Patients who have had previous treatment except for Physiotherapy or shoe lift.

In some cases SpineCor has shown to be effective after rigid braces,- only if the rigid brace has been worn for less than 6 months and the neuro-muscular system is not significantly affected.

Patient compliance also needs to be considered. Your doctor or specialist treatment provider will need to carry out a comprehensive assessment before advising on suitability of SpineCor treatment after rigid bracing.

Patients with congenital defects.

Any patients treated outside the above indications must be considered experimental and informed consent obtained from patients. Out of indication treatments are the responsibility of the prescribing doctor; The Scolisois Specialist cannot accept any responsibility for such treatments.

SpineCor Physiotherapy Program

2007-06-04T22:05:00.000-07:00

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.

Patients treated with the SpineCor brace must only carry out the exercises exclusively designed for his/her type of scoliosis curve to avoid interfering with the action of the brace.

Patients treated with the SpineCor brace must not carry out any other exercises program than the one designed to be performed in conjunction with the SpineCor® brace treatment.

Therefore, all physiotherapists working with patients treated with the SpineCor System must follow a specific SpineCor Physiotherapy Training Program, in order to learn the treatment principles and understand the new treatment approach, to be accredited as Authorized SpineCor Physiotherapists.

SpineCor Physiotherapy Treatment Principles

The SpineCor Physiotherapy Program exercises comply with and follow the Corrective Movement Principle, helping to integrate it, in order to:

Obtain a faster consolidation of progressive curve reduction.

Improve the neuro-muscular integration and postural reorganisation.

The SpineCor Physiotherapy Program mainly addresses:

POSTURAL RE-EDUCATION EXERCISES: to encourage the integration of the Corrective Movement.

MUSCULAR RE-BALANCE EXERCISES: global muscular work, by eccentric contraction of shortened muscles and concentric contraction of extended counter lateral muscles at the same time, starting from Corrective Movement position, reinforcing this Corrective Movement and looking for postural over-correction.

RESPIRATORY EXERCISES: done in combination with postural re-education and muscular re-balance exercises.

Scoliosis Glossary

2007-05-24T13:23:00.000-07:00

Scoliosis: 3D deformation of the spine which, when measured by X-ray, is greater than ten degrees (Cobb angle). In most of the cases, it also shows a rotation of the vertebrae within the curve. Often there is some modification of the normal kyphosis and lordosis angles of the spine.

Idiopathic scoliosis: a structural 3D spinal curvature for which cause has not been established yet. (N.B. Research, however, points to a genetic cause and asymetrical growth, muscle imbalance and neuro-muscular dysfunction as factors leading to progression of curves.)

Infantile scoliosis: 3D curvature of the spine that develops before three years of age.

Juvenile scoliosis: 3D curvature of the spine that develops between the ages of three and ten years

Adolescent scoliosis: 3D deformation of the spine that appears before the onset of puberty and before skeletal maturity.

Adult scoliosis: scoliosis of any cause, which is diagnosed after skeletal maturity.

Congenital scoliosis: scoliosis due to bony abnormalities of the spine present at birth. These anomalies are classified as failure of vertebral formation and/or failure of segmentation.

Neuro-muscular scoliosis: a form of scoliosis caused by a neurologic disorder of the central nervous system or muscle.

Kyphosis: a posterior convex angulation of the spine as evaluated on a side view of the spine. Contrast to lordosis.

Lordosis: an anterior angulation of the spine in the sagittal plane. Contrast to kyphosis.

Kyphoscoliosis: a structural scoliosis associated with increased roundback.

Thoracic curve: any spinal curvature in which the apex of the curve is between the second and eleventh thoracic vertebrae.

Thoracolumbar curve: any curvature that has its apex at the twelfth thoracic or first lumbar vertebrae.

Lumbar curve: a spinal curvature whose apex is between the first and fourth lumbar vertebrae (also known as lumbar scoliosis).

Lumbosacral curve: a spinal curvature whose apex is between the first and fourth lumbar vertebrae (also known as lumbosacral scoliosis).

Primary curve: the first or earliest curve to appear.

Double curve: 3D curvatures (scoliosis) in the same spine. Double major curve: describes a scoliosis in which there are two structural curves, which are often of equal size. Double thoracic curve: a scoliosis with a structural upper thoracic curve, as well as a larger, more deforming, lower thoracic curve, and a relatively non-structural lumbar curve.

Structural curve: a segment of the spine that has fixed 3D curvature.

Non-structural curve: description of a spinal curvature or scoliosis that does not have fixed residual deformity.

Compensatory curve: in spinal deformity, a secondary curve located above or below the structural curvature, which develops in order to maintain normal body alignment.

Spondylolisthesis: an anterior displacement of a vertebra on the adjacent lower vertebrae.

Decompensation: in scoliosis, this refers to loss of spinal balance when the thoracic cage is not centred over the pelvis.

Risser sign: used to indicate pelvic maturity, this refers to the appearance of a crescentic line of bone formation, which appears across the top of each side of the iliac crest used for global appreciation of skeletal maturity.

Scoliometer: a proprietary name for an inclinometer used in measuring the gibbosity (proeminence).

Posterior fusion: a technique of stabilizing two or more vertebrae by bone grafting (Posterior approach).

Anterior fusion: Fusion of the spine by an anterior (Frontal) approach by the thorax and/or the retroperitonal approach

Vertebral column: Pre-load polyarticular system composed of vertebrae, separated by discs and bound together by ligaments.

Cobb Angle: A method of measuring the size of scoliotic curves expressed in degrees.

For more on Scoliosis go to http://www.scoliosisspecialists.com