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A New Alternative Treatment for Idiopathic Scoliosis

"During a recent school screening, it was determined that your son/daughter may have a condition called scoliosis, or curvature of the spine. Please consult your physician for further information and available treatment options."

For most parents, this news can be both alarming and confusing, especially when a child appears to be both healthy and active at the time of diagnosis. Clearly, routine spinal screenings have done much to increase the population’s awareness of scoliosis in general, but serious questions rarely arise until a parent discovers that his or her child may have the disorder.

What’s the best way to treat scoliosis?

This is the first and most obvious question parents ask following an initial diagnosis. The answer is determined by such factors as age, gender, and degree of curve and usually involves the following three options: (1) watch and wait, (2) fit the child for a rigid brace, or (3) schedule spinal surgery. Regardless of the preferred option, however, parents usually experience some feelings of guilt and fear related to their treatment of choice. For example, those who choose to watch and wait often wonder, “What if we do nothing, and then the problem gets worse?” Others, however, who opt to have a child fitted for a rigid fitted brace still worry because correction always depends on compliance: “Will my child feel too embarrassed to wear the device?” “Will it restrict my child’s motion to the point of altering personality?” “What will happen to my child’s back if he or she decides to stop wearing it?” These are serious questions, to be sure. But the final option, invasive surgery, causes parents the greatest anxiety, and rightfully so, with questions such as: “How dangerous is this surgery?” “What’s involved in my child’s post-surgical recuperation?” and “Can our family afford this investment of both time and money at this point in our lives?” Unfortunately, there are no easy answers to these questions. And regardless of professional advice, parents still worry about the choices they have made. Recently, however, a new alternative has been announced, and for countless children diagnosed with minor idiopathic scoliosis, this treatment may be the one that some parents have been waiting for.

SpineCor: An Innovative Approach to Corrective Bracing

On September 16, 1998, at an orthopedics symposium in New York City, Dr. Christine Coillard and Dr. Charles Rivard, pediatric surgeons from Sainte-Justine Hospital in Montreal, presented clinical findings on a promising, new, therapeutic approach for idiopathic scoliosis. As pediatric orthopedists, Drs. Coillard and Rivard had long concurred that bracing was the most conservative option available for children with minor scoliosis. However, they also realized the challenges presented by a child’s growth patterns as well as his or her physical and psychological need for normal mobility. Their studies were based upon these challenges, and as a result of their research, the SpineCor bracing system evolved. Together with their team of researchers from anthropology, biomechanics, and physiotherapy they seek to minimize the three dimensional deformity of scoliosis by addressing what they believe to be four important aspects of the condition, deformation of the spine, postural disorganization, muscle dysfunction, and unsynchronized growth.

What’s different about the SpineCor brace?

Primarily, the SpineCor bracing method is an adjustable, non-invasive technique that provides flexible, inconspicuous correction that continues as a child moves and grows. Unlike traditional rigid systems, the SpineCor brace consists of four major components: (1) a plastic pelvic base, (2) a cotton bolero or vest, (3) tie bands and (4) four adjustable or “dynamic” bands. Proponents of the brace, distributed by Biorthex, Inc., state that this unique combination of components is simple to use, comfortable to wear, and most importantly, effective in its results. The goal of the dynamic brace is to maintain and improve spinal deformity while re-educating the body to return to a more normal posture.

Does the SpineCor Brace work for everyone?

None of the current braces will work for everyone, and SpineCor is no exception. Biorthex states that results so far are similar to other braces for curves greater than 30 degrees and “the best results” occur with those patients who are skeletally immature with Cobb angle curvatures of less than 30 degrees. While determining the initial degree of measurement is essential to the success of the SpineCor system, the growth velocity of the curve is an even more important factor to consider when choosing the SpineCor brace. Specifically regarding such rates of growth, children experience three major growth spurts that can impact the severity of scoliosis: infantile (before age 2), juvenile (between ages 5 – 10), and adolescent (age 11 or the onset of puberty). Based upon clinical studies with children of all ages, the SpineCor system appears to provide greatest benefit to children between the juvenile and early adolescent stages, which generally occur between the ages of 6 and 11. In addition to the patient’sage, two other factors also tend to influence the success of this bracing alternative. As such, children who are either clinically obese, or girls who have already begun menstruating, would not be considered primary candidates for this type of treatment.

How can a patient get started with the SpineCor system?

Because the system is new, not all physicians are currently equipped to treat patients with the SpineCor brace, but information is readily available to qualified practitioners who routinely diagnose idiopathic scoliosis. The orthopedist may use the digital imaging system and assistant software in their office, or arrange an appointment with either an orthotist or a physical therapist to take the initial body measurements and to arrange for follow-up visits. The brace will then be fitted, and the patient is taught how to use it effectively. Generally, to achieve maximum results, the brace should be worn during the day and may be worn for up to 20 hours at a time. Therapists may offer suggestions for improved body mechanics while wearing the brace, and follow-up visits may be needed every 3 to 6 months, depending on the patient’s growth, to make the necessary adjustments to the elastic bands.

What are the expected results of using the SpineCor brace?

Data from clinical trials presented at the New York symposium in September 1998, revealed the following findings. Specifically, from August 1995 to the present, 41% of patients who met the diagnostic guidelines of skeletal immaturity with a progressive curvature of less than 30 degrees have experienced improvement using the SpineCor system. Among these patients, their curvatures were reduced by 25% to 50%. The study also indicated that another 41% of the patients showed no improvement after using the SpineCor brace, but to date, their curvatures have remained stable. Only 4% of the patients treated with the SpineCor brace noted an increase in their initially diagnosed curvatures. These results so far are very positive, however more long term "out of brace" data will be needed to conclusively show the effectiveness of SpineCor.

How can I receive more information about the SpineCor bracing system?

As with any new mode of treatment, it is always best to begin by speaking with your family physician or a referred specialist. This system shows great promise for young children with mild curvatures, and it will be considered among the available scoliosis treatment alternatives. However, you may wish to review the product information before deciding to use the SpineCor system. In order to make the most informed decisions possible, you may contact the NSF office to ask about the device, or you can contact Biorthex, Inc. directly by calling (514) 382-4800 or visit their website at www.biorthex.com.

The Pioneers of the SpinCor Brace

Dr Christine Coillard, Clinical Assistant Professor, Department of Surgery, University of Montreal, and Pediatric Orthopedic Surgeon

Dr Charles H. Rivard, Pediatric Orthopedic Surgeon and Head of the Department of Surgery at the University of Montreal


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