spine-cor vs. Boston brace

[Celia]

Thank you! I would appreciate it if this was brought to the attention of Joe O'Brien once and for all.

That's exactly what I did!

[structural75]

Thank you, again.. I dropped him a note as well.

[cherylplinder]

Chiros charge about 3500 dollars for an assessment for these fringe treatments. I am specifically addressing vestibular rehab for scoliosis. Without any published scientific evidence to support the claims that vestibular rehabilitation can cure or do anything to correct a scoliotic curve, the EXORBITANT FEES are unethical.
Desperate parents are often willing to do anything for correction.

I am not attacking anyone with this statement, but the other side of the coin should be presented each time.

[braceguy76]

Braceguy,

1. I private messaged you with those questions/comments to keep this junk off the public forum. Why are you bringing it back here? Other folks have suggested we settle our disputes outside of this arena and out of respect for them I was trying to do just that. How do you know it wasn't the patient herself?

2. I don't have an agenda... If you were to read the posts that I have put up on this forum (aside from all of the defensive arguing) you can see that I'm not here to promote myself or chiropractics. I have been offering advice in the way of pain management and ways to enhance the effectiveness of bracing, of any kind. I don't have anything to sell... it just upsets me that people are not given the opportunity to hear about adjunct methods that may be of beneficial use to them. You came onto this forum with some very useful input on the topic of bracing and growth factors etc.... but when you began trashing an entire profession and other methods being utilized by those professionals you crossed a line. Dismissing exercise programs without giving any clinical reason why that wouldn't be helpful is inappropriate. To just say that something is non-sense doesn't justify its dismissal.

It seems as though prominent voices on this forum have chosen to eliminate the possibility that any non-surgical treatment besides bracing is irrelevant to scoliosis and I find that completely absurd. I don't have all the answers.... but I'm interested in asking reasonable questions. Neurological components to this condition are a sound basis for 'reasonable' question and inquiry. And it has been shown in studies that vestibulo-ocular asymmetries exist in patients prior to the onset of an ideopathic scoliosis... Which would give adequate reason to treat these individuals with vestibular rehabilitation. You may think it's a bunch of non-sense and choose to degrade it, but I don't see you, or anyone else, offering additional treatment options beyond bracing (which is not always successful for every person). So for those who aren't getting the results that some folks here are getting with the 'miracle' brace, what can you say to them? Sorry, hope is lost? These other approaches may prove useful...

Braceguy, I don't have an agenda other than to keep the voices of the minority heard and try to support the "fringe" treatment options that are often too quickly dismissed because they are not mainstream or well understood. Think what you like about me, but am I really the only person here to find your negative rant about this stuff and subsequent removal of it a little odd as well? One minute you're threatening another forum member with violence and the next you're blessing everyone with the lords name. It just doesn't add up to me... then again, it doesn't have to...

certainly someone with your intelligence understands Sarcasim,Like I could really snap a spine thru the computer. Like I knew at the time who sportsdoc was or where to find him to perptrate this Violence. it was an attempt at levity(I know you don't know that concept)As I have said before I was not trashing an entire profession or trashing pine cor.You simply latch on to what suits you then try and start an arguement. You hav to remember the emails,Epost etc. Can be taken sometimes outside the spirit in which they were offeredI posted your Private message here to show I have nothing to hide. So your otherside of the coin as you call it can be see.You were the guy that wants the whole truth are you not?You on the other hand seem to have at least an association of sorts with my former employer or you would not be privy to the info of my Divorce.
As for blessing or wishing other well I'd thought that would be ok with you, Do you have something against god? I bet you don't mind "In God we trust" LOL ( sarcastic remark)

[christine2]

Somebody

Please move this bickering junk out so us parents may converse and so the new parents to the forum can get some help!!!! This stuff is damaging this wonderful forum!!

[structural75]

Maybe someone here who was/is actually a patient of Dr. D's can give us accurate insight into the fee schedule for this type of testing... I thought I read a post by someone once saying that it was between $700 - $1200.??? What do MDs charge for vestibular testing? And I'd agree, excessive fees are shameful.

Cheryl I respect your willingness to try a "fringe" treatment. I think that those who interpret them to be supposed "cures" are misrepresenting what they are meant to do. Braces don't "cure" scoliosis either... they force the curves back, plain and simple... but do very little, if anything at all, to actually "cure" the initial cause. Cheryl, I'm certainly not saying that to pick on your choice of words, I just keep hearing that phrase from folks as if everything that's presented as a form of 'treatment' is supposed to be the "cure"... when maybe we should look at all of these things, bracing and surgery included, as ways to slow, stop or reverse its progression, part of a comprehensive process. But until we have a better understanding of its variety of causes I don't think that anything can be considered a "cure".

[MATJESNIC]

Structural,

What I resented, more than the fees for the test (I know I paid at least $1,500 because even though she fell within normal range, they wanted to test that the exercises were improving any weakness, so there was re-testing) was that getting the Spinecor brace was packaged in with the testing. Nobody asked if we wanted the testing. It was a package deal. And now I know that it wasn't right. It should have been presented as an option.

[structural75]

Melissa,
I'm very sorry to hear that. I agree that you should have had the option. I don't support the idea of "package" deals or offers... that sounds like something that belongs in retail, not medicine.

Thank you for sharing that info with me. I don't support that kind of practice and I appreciate your frank opinion on it.

Structural

p.s. - Did the second run of test show any positive effect for your daughter?

[MATJESNIC]

Structural,

I only know what they told me. She didn't have anything outside of normal to begin with. But the areas that were on the weaker side improved after exercise. This was based on their testing. They could have told me anything and I would have just taken their word. What do I know. The big question is how did any of that change her curves in any way. Probably not at all. Maybe if you are someone who has some real deficits, but Nicole didn't.

I was vulnerable. I didn't want the hard brace. I felt good about Spinecor because it was better than doing nothing. It never occured to me to go to Montreal. Going to New York made the most sense. So whatever the price was and whatever the package was, we just went for it.

I have always said that Dr. D. was nothing but kind and patient with my daughter. He spent a very long time with us at all of our appts. We were never rushed. But it was expensive.

[structural75]

To all,

Braceguy and I have taken our discussion to the private sector and our conversation has moved us forward. I do want to offer my apologies to him for some of the remarks I made about his personal life and accusations about him based on here-say. I had no business using that information to question his credibility and bringing someones personal life matters into this was out of line....

My frustrations with other folks has gotten the best of me in this situation. I don't condone the practices he was describing by anyone and I hope that nobody here finds themselves a victim of it in the future. I do hope that people will keep their minds open to more comprehensive treatment methods despite a few bad apples out in the world. There is much for you all to gain by some of the lesser known treatment methods... And while no single method will be right for all, let common sense be your guide.

Again, my apologies to braceguy for any hurtful or accusatory remarks.

Kind Regards,
structural

[braceguy76]

Thank You

Thank you Structural,

I agree that there is no place for insults here.But at the same time these people, who are here searching for answers and alternatives for their children nedd to know that there are "sharks in the water".
I think you can agree considering the sourse of the information that everybody here needs to really research not only the method of tratment chosen but the practittioner as well.
Thanks again Structural

[structural75]

I absolutely agree! You're welcome, it was the least I can do.

[braceguy76]

studies and protocols

I intend to post here serval diferent brace protocols and studies.I am doing this so we can get back to meaningful discussion of each option.Also to impowe you as parents to know where the actual protocols stop and the practitioners preference takes over.This is only to let you know where you can say to you practitioner wether or not you'd like to try any thing outside these protocols.
I hope this will help and if you feel this will clutter the board please let me know and I will not pot these here.After all this is YOUR forum and as a Practitioner I am here only to provide information.
I will be awaiting your responses before posting anything

[braceguy76]

spine-cor protocol

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 2. The brace is fitted on the patient in accordance to a sub-classfication of the
traditional SRS definition of curve types. The SpineCor Assistant Software guides the therapist 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 the growth of the patient, components to the brace are expected to be changed every
1.5 to 2 years. A patient manual is provided that guides the patient in properly wearing the brace, as well as maintenance.
The orthotist is suggested to follow a 2day training program to learn the the proper fitting of the SpineCor brace.
INDICATIONS
The SpineCor System was designed, developed, and tested for the treatment of idiopathic scoliosis only.
CONCEPT
The new therapeutic approach is based on a new concept upon the etiology and pathogenesis of idiopathic scoliosis. It is
a pathology of the neuro-musculoskeletal system in growth and maturation. The cause is genetic, and the pathogenesis
involves a three-dimensional deformation of the spine, postural disorganization, unsynchronized growth and particular
movement pattern of the body.
DIAGNOSIS
In order to obtain an accurate diagnosis, that would specify a particular class and subclass for the patient, the evaluation
combines a clinical exam, radiological and postural evaluation.
TREATMENT
A specific corrective movement is performed, and the brace is applied according to the SpineCor Assistant Software
instructions. The moderate tension in the elastic bands allows the repetition and amplification of the corrective movement
as the child undertakes everyday activities. This results in a progressive curve reduction. The brace is worn 20 hours out
of 24. The four hours out of the brace must not be taken at once, usually the patient divides them into two breaks: morning
and evening. Sports are to be encouraged and done while wearing the brace. To obtain a neuro-muscular integration of
the new strategy of movement, the average duration of the treatment is 18 months. Because of the progressive changes,
absence of external support during the treatment, and intact muscles, there is no loss of correction after the brace
discontinuation. Physical therapy is NOT a necessity in the SpineCor program (SpineCor itself may be considered a
physiotherapy 20 hours out of 24). However, when the patient is willing to undergo a physio program, or a faster
consolidation of the reduction of the curve is desired, the Global Postural Reeducation (GPR) program is considered. For
the patients at the beginning of the treatment, the physio is carried out with the brace on; for the patients in the weaning
period the exercises are done without the brace.
PROGNOSIS
To really change the natural progression of idiopathic scoliosis, it is essential to reduce the curvature enough to eliminate
the negative impact of abnormal biomechanics and growth. Therefore, it is possible to achieve a complete or almost
complete correction of moderate curves, if the treatment is started before the main growth spurt (before Risser 1 and
menarche). In curves over 30 degrees of Cobb angle, or when the treatment started during or after the main growth spurt,
the goal of the treatment is a stabilization of the deformity. The therapeutic success is possible in more than 80% of
cases. The reference reducibility calculated as early as at 3-4 months of treatment, is useful in defining the prognosis.
However, for individual prognosis, the impact of the severity of the bone deformation, pattern of the growth and
compliance must be considered.
This come directly from the manual.If you have any type of scoliosis other than idiopathic this brace is contrindicated for you.Also were therapy is advised by you have the option to opt out.Notice also that Vestibular testing and rehab are not part of this treatment plan.Anything other than what you see here should be your option and your provider should tell you in advance that this is not part of the standard treatment.what this says is simply if the brace is applied correctly to the right canidates with proper follow up the results should be as there study shows.I will also post there study.So don't feel obligated to follow a plan your not comfortable with.this information was found online in case anyone cares to know.

[braceguy76]

Srs Brace Mannual

THE SCOLIOSIS RESEARCH SOCIETY BRACE MANNUAL
INTRODUCTION
Dale E. Rowe, M.D.
Kalamazoo, Michigan
Idiopathic scoliosis has been divided into Infantile (IIS), Juvenile (JIS), and
Adolescent (AIS) forms 67. Recent researches into the early onset types of scoliosis (IIS
and JIS) have pointed out that about twenty percent of these patients have neuro-axis
anomalies which may contribute to the development of a curved spine 19. These types of
curves in all patients under ten years of age may not actually be “idiopathic” in nature.
For this reason, the natural history of these patients is different from the behavior of late
onset scoliosis (AIS)8. Long term outcome studies of untreated patients with AIS have
demonstrated that these curves will worsen when they are 50 degrees and more at
maturity 56. Thoracic curves more than 80 degrees are associated with shortness of breath
and risks of cor pulmonale and death. Patients with this degree of scoliosis will have
more concern about their cosmetic appearance. Many patients with AIS have more pain
but do not exhibit more disability than the general population. Depression does not seem
to be more of a problem than in the general population 79. Patients with curves less than
45 degrees have lives with quality and length equal to those of control subjects. Both
non-operative and operative treatments, therefore, aim toward keeping patients’ curves
under the important threshold of 50 degrees at maturity.
Non-operative treatment of scoliosis has been depicted as early as Hippocrates, in
art and literature, using traction and lateral localizer straps. Modern bracing is said to
have started with Blount and Schmidt in 1946 5, when they started using a brace
developed for post-operative immobilization for non-operative treatment. This
"Milwaukee Brace" used metal uprights to give a distraction effect to a sub-mandibular
molded pad. Lateral straps and pads were placed over the apex of sclerotic curves to add
lateral bending moments to the treatment, along with distraction. The brace was intended
to stimulate the patient to pull away from the contact points thus using muscle power to
correct the curve. Close observation indicated that those patients treated with the
Milwaukee brace did not progress as often as those untreated. The standard treatment
protocol became full-time wear for the duration of growth for all patients found to have
scoliotic curves from around 20 degrees to 45 degrees. Physicians found that bracing did
not generally change the natural history of scoliosis if the curves were greater than 45
degrees.
Patients apparently followed Dr. Blount’s instructions well, but others found the
constraints of a rigid brace from the chin or throat to the pelvis uncomfortable and
unsightly. Hall and Miller 22,76 developed a more total contact brace that works as a sleeve
the patients and improve compliance. The outcome of the Boston Brace on the scoliosis
progression was the same as the Milwaukee Brace.
Green 18, 33 found that adolescents often did not wear their braces as long during
each day as was prescribed. He suggested that it was possible to have the children wear
their braces part-time and achieve the same control of curve progression. Variations of
the treatment protocols for the Boston Brace were developed. The Charleston Bending
Brace, Providence, and others, which were specifically built for nighttime wear. 6,14,23.
These braces bent patients out of their curves. Other mechanisms of treatment used
electrical stimulation of trunk muscles to bend patient out of the curves 2. They
suggested that a treatment period of nighttime or eight hours was adequate to keep
scoliosis from progressing.
Manipulation and exercise therapies have been tried largely based on theory or
anecdotal experience. There are no studies which prove or refute chiropractic