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Thread: Spinecor and JIS

  1. #1
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    Spinecor and JIS

    http://www.ncbi.nlm.nih.gov/pubmed/21067608

    Scoliosis. 2010 Nov 10;5:25.
    SpineCor treatment for Juvenile Idiopathic Scoliosis: SOSORT award 2010 winner.

    Coillard C, Circo AB, Rivard CH.

    Sainte Justine Hospital, 3175, Chemin de la Côte-Sainte-Catherine Montréal, H3T 1C5 Quebec, Canada. chrivard@gmail.com.
    Abstract

    INTRODUCTION: Juvenile idiopathic scoliosis is a condition used to describe patients who are least 4 years of age but younger than 10 when the deformity is first identified. In these patients, the condition is usually progressive and those that are diagnosed at five years or younger have a high chance of progression to a large curve, with additional pulmonary and cardiac complications. The main form of conservative treatment for juvenile scoliosis is the use of a bracing system. This prospective interventional study was conducted to evaluate the effectiveness of the Dynamic SpineCor orthosis for juvenile idiopathic scoliosis as well as to evaluate the stability of the spine after the weaning point.

    MATERIAL AND METHODS: For this study, 150 juvenile patients were treated by the SpineCor orthosis between 1993 and 2009. Of these, 67 patients had a definite outcome and 83 are still actively being treated. To determine the effectiveness of the brace the OUTCOME criteria recommended by the SRS was used.

    RESULTS: The results from our study showed that of the 67 patients with a definite outcome, 32.9% corrected their Cobb angle by at least 5° and 10.5% had a stabilization of their Cobb angle. Within the patients with a definite outcome, 37.3% of patients where recommended for surgery before authorized end of treatment. For this group of patients, surgery was postponed. Looking at the stability of the curves 2 years after the end of the treatment, we found 12.5% of the patients continued their correction without the brace being used and 71.4% remained stable.

    DISCUSSION: From our study we can clearly see that the effectiveness of the SpineCor orthosis in obtaining and maintaining the neuromuscular integration of the corrective movement can be achieved effectively for juvenile patients. Over 75% of all patients that finished the treatment had remained stable with a few continuing to correct their Cobb angle after the use of the SpineCor orthosis was discontinued.

    CONCLUSION: Our conclusion from this study is that the SpineCor orthosis is a very effective method of treatment of juvenile idiopathic scoliosis. The results obtained also indicate that treatment outcomes are better with early bracing. Most encouraging perhaps is the fact that the positive outcome appears to be maintained in the long term, and that surgery can be avoided or at least postponed.
    I'd like to read this paper to see what they mean by certain terms.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989306/

    From the article...

    Another limitation of the present study is that the proportion of thoracic/thoraco-lumbar/double curves in this study does not reflect the real proportion seen in the general population.
    Kudos for admitting that and thereby acknowledging the differences in progression potential. This is why when papers like Katz et al., although only having a few lumbar and T/L cases, need to say where they fell out. For all we know, the lumbars were all stacked in one group for whatever reason, maybe brace comfort. There were 100 patients and about 10% were L or T/L. Who knows... the point is that mention of it was conspicuous by its absence.

    I just scanned the article... I'll finish reading it later.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    Okay I read the article.

    I think a case can be made that averaging data as in this article and any number of other articles obscures rather than throws light on the situation. I think drilling down and keeping the data points straight would show that the results are similar to natural history or to other bracing regimes. I keep wondering if the data can be presented more clearly. The bottom line is beating natural history and the rest strikes me as obfuscation.

    Step 1 - what is the natural history. Only move on to Step 2 if this is known.

    Step 2 - does the treatment beat natural history?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    I also did not see mention of what degree of curvature these patients had. I wonder about this because I have heard of so many patients wearing the Spinecor who have curves of 10 or 15 degrees.

    Of course it us purely anecdotal, but the cases I've heard of where the patient's curve was larger (30, 35, etc.), several of those patients progressed and went on to fusion.

    I also don't know how the authors can be certain that surgery was delayed solely because the patient wore their brace. How can we know at what point these patients would otherwise have moved into surgical territory? From the several cases I know of where a Spinecor wearer needed fusion, it was at the time of their major growth spurt.

    I still have many, many questions.
    Last edited by mariaf; 01-02-2011 at 06:50 PM.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

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    Good points there, Maria.

    My overall impression is that I think people who doubt the Spinecor literature have ground to stand on.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    Agreed. And I think you nailed it when you asked if the treatment beats natural history.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

  7. #7
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    Quote Originally Posted by Pooka1 View Post
    and the rest strikes me as obfuscation.
    And also obscurantism. (smiley face)
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  8. #8
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    Here are some more descriptors that might apply...

    http://freethesaurus.net/s.php?q=dark

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    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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