Are improvements from bracing permanent?

[gerbo]

orthoman, if you see these corrections; http://skoliose-info-forum.de/viewtopic.php?t=957 it must make you drool. Ofcourse, this table only gives initial corrections and no endresults, but if one orthotist can achieve these kind of corrections, should all orthotists not have a "moral obligation" towards their patients to find out how he does it and learn to replicate his techniques and results?? Shouldn't the average try to learn from the best??

[gerbo]

ps, i was going to comment on the wonderful quality of your local football team, but after the latest results you might feel a bit sore and rather not be reminded....

[Celia]

If the best that can be hoped for is maintaining a curve at pre-brace levels, where does the logic behind watchful waiting come in? A curve above 10 degrees is defined as a medical condition called scoliosis - does it make any sense whatsoever to watch a curve progress to 25 degrees before starting treatment regardless of age??? For juvenile curves, 25 degrees is already too late for a vast majority of these children as they enter the adolescent growth spurt since 75% of these children will progress to surgery levels! Granted many cases are caught too late and little can be done other than maintenance or surgery however....how can one justify the current standard of care??? Why aren't user friendly braces like the spinecor more widespread? With the exception of the spinecor that is specifically designed for small curves, I strongly feel current rigid bracing is very much in the dark ages and has been for quite some time.

Does anybody know whether the Boston brace subject to as much scrutiny and testing when it was first introduced in the seventies or early eighties? I don't believe it was.

[LindaRacine]

Hi Celia...

I think we may have had this same debate before.

The vast majority of kids with 10 degree curves will never go on to have a significant curve. Putting them all into a brace would only further serve to bankrupt the system. Bear with me as I do some math, which may or may not be completely accurate, but it should give you some idea of the problem. In the US alone, it's estimated that about 3 million people have scoliosis curves of 10 degrees or more. At the most, about 300,000 of those 3 million people will ever have any reason to be treated. Would you be willing to pay your share of the almost $7 billion cost? Even if my numbers are off by 75%, it's still a significant cost.

And, would this scenario stop at scoliosis braces? There are probably hundreds of other conditions that have preventative treatments that aren't cost effective. For example, I think I've heard that at least one in nine women will develop breast cancer in their lifetime. If we had a vaccine that cost $1,000, would it make sense to vaccinate all women? (A cool $150 billion in the US alone.) Or, would it be more cost effective to vaccinate only women who have the breast cancer gene, or have had breast cancer in their family.

Fortunately, it appears that in a very short time, we'll have a test that will fairly accurately predict which kids are at risk of progression. Once that's available, this debate will be a distant memory.

Regards,
Linda

[orthoman]

Gerbo you made me drool a lot, the results are fenominal, i must say . i want to learn more about this way of making. and yes i to find that if one get's these results more people should learn how to get it that way.

Footbal is lukely enough not my biggest pasion , otherwise i would be very down at this moment.

Celia: there are more braces like spinecore, here in holland we use also a brace called Triac ( http://www.scoliosis.nl/ ) but it's only used in mild curves not in big curves.I have to agree with lindaracine that to put every one in a brace would become to expencive .and with small curves we do not have to put everyone in a brace, in holland we start bracing after 25 degrees.

i took an other look at some results of mr. Rahmouni, i have een results ( x-ray's ) and i was flabergasted. one patient was 45th and 42 lu to olmost zero degrees after using the brace for 3 years what it dind say was the age of the patient , but still a marvelous result ( other results are aprox. 50 procent improvement, very good results) ( it's all done with custom made brace's mr. rahmouni made a compilation of ceveral type's of braces as far as i could see on the pictures. and developed a specific brace for his "hospital" .)

[Celia]

I still don't see how preventative treatment will bankrupt the system. Why wait for a curve to progress to 25 degrees? Why not start treatment when there has been documented progression to 15 or 20? People with small curves suffer from back pain and put an enormous strain on the health care system. Think of how much money insurance companies will save on spinal fusion and repeated revision surgeries - these surgeries don't come cheap. I still believe excessive surgery/medical costs in addition to military spending on wars waged in distant countries will bankrupt the system and be one of the causes leading to the downfall of the U.S. through civil unrest. Oops, I got a little carried away....

[orthoman]

there are many people who don't even know that they have a curve, the patient's who do have a curve are monitored . an dif the curve progresses action can be taken, with treatment.As soon as we know that someone has a curve we don't say "go home it's nothing to worry about". We tell them what kind of treatments there are, what if what if and what if. Good information is the half treatment.and the patient knows what he's up to.