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Thread: Janzen Bracing System for JIS

  1. #91
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    Quote Originally Posted by Dustin76 View Post
    See this literature review. AIS curve reductions happening?

    Bracing - Halting Progression or Improving Curves in Adolescent Idiopathic Scoliosis
    Wing-Yan CHAN1*,Shu-Yan NG2, Tsz-Ki HO1, Yin-Ling NG1

    https://symbiosisonlinepublishing.co...diseases06.php


    "Results show that there has been an apparent improvement in the effectiveness of bracing in reducing surgical rate since 2005. Close inspection shows that the reduction in surgical rate is not due to an improvement over time, but is related to the types of brace. The effectiveness of Boston brace is not consistent over the years. The surgical rates vary and no consistent trend of improvement can be discerned in the last 2-3 decades. The surgical rate reported in 2007 for TLSO was as high at 79% and that in 2014 for Boston brace was 28%. The surgical rates with European braces (Progressive Action Short Brace (PASB), Cheneau derivatives and Lyon/Sforzesco braces), however, are consistently lower, at less than 8%. Similarly, the European braces have been found to be able to improve curves in over 50% of the at risk patients. Bracing does not therefore only halt progression of curves. Given a well-constructed brace, with good patient compliance, improvement of curves in over 50% of the patients is possible, particularly when used in conjunction with scoliosis specific exercises."
    I did not see where they state when the curve improvement was determined. Was it determined 1 minute after removing the brace for the last time?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

  2. #92
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    Just to chime in

    Quote Originally Posted by Pooka1 View Post
    I did not see where they state when the curve improvement was determined. Was it determined 1 minute after removing the brace for the last time?
    My understanding is that it's not uncommon for (some) studies to show modest curve improvement with bracing (less than 5 degrees) in some adolescents at cessation, but that this improvement almost always is gone at follow-up. This would suggest to me that either they are measuring too soon at the cessation point (which I hope not!), or that there is a small, residual improvement in some kids that persists even after 24-48 hours out of brace, but which gradually progresses back to pre-bracing measurements over the course of weeks or months or years between cessation and follow-up.

  3. #93
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    Quote Originally Posted by Concerneddad View Post
    My understanding is that it's not uncommon for (some) studies to show modest curve improvement with bracing (less than 5 degrees) in some adolescents at cessation, but that this improvement almost always is gone at follow-up. This would suggest to me that either they are measuring too soon at the cessation point (which I hope not!), or that there is a small, residual improvement in some kids that persists even after 24-48 hours out of brace, but which gradually progresses back to pre-bracing measurements over the course of weeks or months or years between cessation and follow-up.
    Agree.
    .
    .
    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."

  4. #94
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    Quote Originally Posted by Pooka1 View Post
    The SRS disagrees. Their field.
    Agreed. Permanent brace improvements are rare, and potentially explained by those who get permanent improvement being those who probably didn't need to be braced in the first place.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  5. #95
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    Quote Originally Posted by Pooka1 View Post
    I did not see where they state when the curve improvement was determined. Was it determined 1 minute after removing the brace for the last time?
    I don't know. I would have to look into the studies that they were reviewing. No time now, but hopefully I will get to it.

  6. #96
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    Quote Originally Posted by Dustin76 View Post
    I don't know. I would have to look into the studies that they were reviewing. No time now, but hopefully I will get to it.
    If in fact they don't discuss this, can you see why this literature is credibly characterized as a train wreck?
    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."

  7. #97
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    Quote Originally Posted by Pooka1 View Post
    If in fact they don't discuss this, can you see why this literature is credibly characterized as a train wreck?

    Yes. Then it would leave the question open as to whether curves can be, or have been, improved and maintained long term. As opposed to, as this literature review suggests, the SRS not even considering the possibility that curves could be, or have been, improved with bracing.

  8. #98
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    Quote Originally Posted by Dustin76 View Post
    Yes. Then it would leave the question open as to whether curves can be, or have been, improved and maintained long term. As opposed to, as this literature review suggests, the SRS not even considering the possibility that curves could be, or have been, improved with bracing.
    You aren't actually suggesting the SRS is not being scientific, are you? Please be assured they have scientific reasons for their claims. They leave the nonsense to the people trained in nonsense, the chiros.
    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."

  9. #99
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    I have been provided with the emails of 5 parents/patients that have been out of brace for quite some time. One so far has allowed me access to the basic case and imaging. I am not going to post the images, so take it for what you want, but it's an AIS case braced for 5 years. The initial greatest curve was 50 degrees. The first out of brace image at cessation of bracing (might have been within minutes) had the greatest curve at 23.2 degrees. The last provided image has greatest curve at 21.2 and was taken at 51 days past brace cessation. The patient in this case is back to normal activity and they have not sought any further imaging. It is just one case and could be an anomaly kind of case, but still impressive to me. I am hoping to see some imaging from someone that is a year or more out.

  10. #100
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    Quote Originally Posted by Dustin76 View Post
    I have been provided with the emails of 5 parents/patients that have been out of brace for quite some time. One so far has allowed me access to the basic case and imaging. I am not going to post the images, so take it for what you want, but it's an AIS case braced for 5 years. The initial greatest curve was 50 degrees. The first out of brace image at cessation of bracing (might have been within minutes) had the greatest curve at 23.2 degrees. The last provided image has greatest curve at 21.2 and was taken at 51 days past brace cessation. The patient in this case is back to normal activity and they have not sought any further imaging. It is just one case and could be an anomaly kind of case, but still impressive to me. I am hoping to see some imaging from someone that is a year or more out.
    Are they still in the brace weaning???

    How old at diagnosis?
    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."

  11. #101
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    Quote Originally Posted by Dustin76 View Post
    I have been provided with the emails of 5 parents/patients that have been out of brace for quite some time. One so far has allowed me access to the basic case and imaging. I am not going to post the images, so take it for what you want, but it's an AIS case braced for 5 years. The initial greatest curve was 50 degrees. The first out of brace image at cessation of bracing (might have been within minutes) had the greatest curve at 23.2 degrees. The last provided image has greatest curve at 21.2 and was taken at 51 days past brace cessation. The patient in this case is back to normal activity and they have not sought any further imaging. It is just one case and could be an anomaly kind of case, but still impressive to me. I am hoping to see some imaging from someone that is a year or more out.
    I'm not saying anything specifically about the families with whom you're in contact, but please be aware that I've seen a few cases of fraud in terms and pre and post bracing. If you really want to know, bring those xrays to your children's specialist the next time you visit, and ask them if they see any potential fraud.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  12. #102
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    Quote Originally Posted by LindaRacine View Post
    I'm not saying anything specifically about the families with whom you're in contact, but please be aware that I've seen a few cases of fraud in terms and pre and post bracing. If you really want to know, bring those xrays to your children's specialist the next time you visit, and ask them if they see any potential fraud.
    I get what you are saying and that is not out of the realm of possibility. It would be quite the conspiracy though. I won't base my decisions on this one case or even a few more cases. I would potential switch my kid's care to someone like Grant Wood, CPO for a number of reasons with insurance coverage being a big one. I basically got his name from an article that Sharon posted, so thanks Sharon. He actually just called me back for a couple minutes. I am sending our kid's images to him and then he and I will talk in detail.

  13. #103
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    Quote Originally Posted by Pooka1 View Post
    You aren't actually suggesting the SRS is not being scientific, are you? Please be assured they have scientific reasons for their claims. They leave the nonsense to the people trained in nonsense, the chiros.
    I'm not suggesting that they are not scientific. Maybe they are a little behind with doing literature reviews? I don't really know what all goes into their "position statements", but the proposition that AIS curves never improve doesn't match this literature review to which I was referring where they looked at over 500 studies from 1990 to 2016 - granted only 53 studies met inclusion criteria, but that is typical to have a lot of poor studies out there in any field with lots of studies not meeting criteria. Literature more often than not for any topic could probably fit the "train wreck" category. A lot of times, it is just information to help decide how to roll the dice. But it's still a roll of the dice. That's why I'm hesitant with hard conclusions like "this can never happen or hasn't happened" when it doesn't seem so settled. I'm just not going to put all my money on what the SRS says. For me, I'll take all the information from all the sources that I can find including this forum which has been helpful. And I appreciate the time you have taken out of your days to respond to me. I value the experiences with bracing of the practitioners and families/patients as well.

  14. #104
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    Quote Originally Posted by Dustin76 View Post
    I get what you are saying and that is not out of the realm of possibility. It would be quite the conspiracy though. I won't base my decisions on this one case or even a few more cases. I would potential switch my kid's care to someone like Grant Wood, CPO for a number of reasons with insurance coverage being a big one. I basically got his name from an article that Sharon posted, so thanks Sharon. He actually just called me back for a couple minutes. I am sending our kid's images to him and then he and I will talk in detail.
    The list of people who have relevant training to be dealing with scoliosis in kids:

    1. board certified pediatric orthopedic surgeons
    2. certified trained orthotists

    The list of people with no relevant training to be dealing with scoliosis in kids and who have ZERO allegiance to intellectual honesty:

    1. chiros
    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."

  15. #105
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    Quote Originally Posted by Dustin76 View Post
    I'm not suggesting that they are not scientific. Maybe they are a little behind with doing literature reviews?
    A MEDICAL society dedicated to scoliosis is maybe a little behind with doing literature reviews? Did you just type that???

    I don't really know what all goes into their "position statements",
    At this point that is a penetrating glimpse into the obvious.

    but the proposition that AIS curves never improve doesn't match this literature review to which I was referring where they looked at over 500 studies from 1990 to 2016 - granted only 53 studies met inclusion criteria, but that is typical to have a lot of poor studies out there in any field with lots of studies not meeting criteria.
    Just because they whittled it down to 53 studies should not be confused with actually having a non-train wreck set of studies.

    Literature more often than not for any topic could probably fit the "train wreck" category.
    Agreed but the bracing literature is a poster child for that.

    A lot of times, it is just information to help decide how to roll the dice. But it's still a roll of the dice. That's why I'm hesitant with hard conclusions like "this can never happen or hasn't happened" when it doesn't seem so settled.
    People who most know what the hell they are talking about have summarized the situation to date. It is ultimately correct? Maybe not. Is it the most honest, knowledgeable read of the literature at the PRESENT MOMENT? Yes. Should chiros be dealing with scoliosis in children? NO.

    I'm just not going to put all my money on what the SRS says. For me, I'll take all the information from all the sources that I can find including this forum which has been helpful. And I appreciate the time you have taken out of your days to respond to me. I value the experiences with bracing of the practitioners and families/patients as well.
    That's fine. It is good to be open minded and take information from various CREDIBLE sources. Where you might be jumping the tracks is the "credible" part. The fact that you are dealing with a chiro on TWO JIS cases is one strike against your ability to discern credibility but we are all pulling for you and will NEVER give up on you. We can't quit you, Dustin!
    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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