spine-cor vs. Boston brace

[mpj]

Another Dr. Opinion on SpineCor

Our Dr. said he thought we had nothing to loose by trying SpineCor, except for money of course. However, he did think the price was "reasonable." He was honest about not knowing too much about it, and said he was uncomfortable that there was not a controlled study done on the brace. However, he said he thought it was fine to go ahead, try it out and see how it works. He also said that we should be prepared to change our plan of action if the brace doesn't work. That sounded like good advice to me, so we went for it. So far, so good. However, one thing to keep in mind is that our daughter's curve was caught at 24 degrees. Not a huge curve, but not something to ignore either. I think our Dr. felt like we had some time to experiment.

Sarah

[malka22]

Christine2:
I am amazed & oh so happy for you that your daughter's curve went from 33 degrees to 5 in a Spinecor !!!!!!!!!!! That is so awesome. I've never heard of any hard brace getting that kind of curve "correction." To my knowledge, all that we can expect from hard braces is for them to HOLD the curves where they are, if genetics allow it. Go Spinecor!!!!

[GeorgiaMom]

We love our chiropractor!

I just wanted to give a follow up to my daughter's progress. I have only posted a couple of times, so I'll include her history as well so that you know the whole story.

My daughter will be 11 in April and at her annual exam last year her pediatrician noticed her shoulders were uneven and suggested we go see an ortho. The ortho diagnosed her with scoliosis with a curve of 6 degrees. He said she may grow out of it and asked that we come back in 6 months for a follow up. In November we went for the follow up and he said her curve had progressed to 34 degrees! He was stunned and wanted her to be fitted for a Boston brace. Of course, we wanted the best for her and dutifully scheduled her appointment with the orthotist for mid-December. At this time we were not aware of any other options besides other hard braces. Fortunately, the day after she was casted for the brace, I read an article in our local paper about the Spinecor brace and learned that the chiropractor who used this brace was just down the street from us! Dr. Brian Ouellette with Maximum Health Chiropractic in Alpharetta, GA, measured her curve at 25 degrees and in brace she was immediately down to 15 degrees!!

3 month follow up visit - Yesterday we had her three month follow up and in brace she is at 6 degrees! Dr. Brian wants her to come back in 3 months for an out of brace x-ray and, if she stays at 6 degrees or is even better, he is going to recommend she stop wearing the brace. We would then continue to monitor her curve, as well as use chiropractic care to maintain or improve, perhaps even to zero! Needless to say, we are ecstatic, especially my daughter, as she may now get to go to summer camp without the brace.

I have to say that I was initially skeptic about the chiropractic care and even the Spinecor, but Dr. Brian has been fabulous and has never taken advantage of our ability to pay. He has trained with the surgeons in Montreal and is in constant contact with the folks who now own the product. In fact, I met Andrew at our visit in January. Dr. Brian does not condone the practices mentioned by other chiropractors in this forum and, I believe, he is the next best option to going to Montreal. We are very fortunate to have him so close by.

I wish you all well and continued success with your children as well.

Melody (Georgia Mom)

[MATJESNIC]

Melody,

Thanks for sharing your story. I am very happy for you and your daughter. There is a young girl named Lauren who wears Spinecor and goes there, I believe.

Just wondering if your daughter has had her major growth spurt yet? This should happen one year before she gets her period. This is the most critical time for young girls with scoliosis. Please be sure she is wearing a brace during that time. That is when things can get very bad. Even Dr. Rivard said sometimes the curve gets worse at this time even while wearing the Spinecor.

If they decide she should take a break from it, I would call Dr. Rivard for a 2nd opinion. You don't want to have regrets later on. I hope I don't come off pushy like I am telling you what to do.

I wish I had known about that for my daughter. But when we found out she was at 40 degrees, her major growth spurt had helped put her at that level. Now we are struggling to hold her curve.

[Celia]

Melody,

I have to echo what Melissa said and err on the side of caution. I remember hearing a presentation where dr. Rivard commented that the *minimum* amount of time in the brace should be two years? Congrats on the GREAT NEWS!!!!!

*****

[GeorgiaMom]

Melissa -
Thank you for your suggestion. We certainly don't want to make any mistakes with taking her out too soon. I am not sure if she has had her "major" growth spurt yet. She grew over an inch between May and November last year and then another inch and a quarter between December and end of January. She is at a risser 0 and has not had her period, but is has been showing signs of puberty for several months.

Thanks,
Melody

[Celia]

Melody,

I remember hearing in one of the SRS presentations that the peak height velocity period ends about 3 months prior to menses. However, that doesn't mean your daughter is out of the woods since doctors found in this one study that roughly 25% of children had the greatest curve progression during risser 4. The numbers are a bit sketchy because the last time I viewed the presentation was about a year and a half ago.... The presentation is here at 10:15 a.m.

Peak Height Velocity as a Predictor of Curve Progression in Idiopathic Scoliosis

Talwalkar, Vishwas

http://www.istreamplanet.com/srs/def...&conf=3&edi=12


*******

[MATJESNIC]

Celia,

Thanks for that. I found that one and the one after that very interesting. Some of it is over my head. But basically I think they are not concerned with risser as much as they are concerned with other things. I am going to make a few notes so I can ask Dr. Rivard some of the specifics about Nicole when I am there.

I do know Nicole had her PHV about 16 months ago. Not sure what that means for her.

When they said some kids progressed during risser 4, did they say whether that was before or after their PHV?

[Celia]

When they said some kids progressed during risser 4, did they say whether that was before or after their PHV?

I just viewed the presentation again. The charts change very quickly so it's really difficult to follow but I think Dr. Vishwas said Risser 1 occurs on average 11 months post PHV and 90% of the patients had completed PHV by Risser 1. Did anyone else get a different answer? So to answer your question....PHV would most likely be over by Risser 4 and children at that point would be in the descending phase of growth. However.... 15% of children had maximum curve progression during Risser 4 so I would think that a small number like 10 - 15% were still going through a PHV at Risser 4 Is this possible?


Melody,

There is also a presentation by Dr. Rivard on that same page and I'm pretty sure he states the minimum amount of time in the Spinecor brace should be 2 years.


*******

[GeorgiaMom]

We have an appointment with Dr. Brian again on Tuesday, so I am going to share this presentation with him and get his input on the recommendation of a minimum of 2 years in brace. I know he was trained by Dr. Rivard, so he should be fully aware of their recommendations. It may be that since we are so close and since we will be seeing him on a much more regular basis that he would be comfortable taking her out of brace and then putting her back in if he sees any progression.

Thanks,
Melody

[gerbo]

previously up from 6 to 36 degrees in 6 months?? I'd be very cautious taking her out too soon. Too much too loose I'd thought. At least get a dr rivard opinion as suggested.

[GeorgiaMom]

Actually, the chiro measured her at 25 degrees before brace. The x-ray the ortho took was incorrect and I could see that with my untrained eye. So, it's really down from 25 to 6 in less than six months. Still a pretty significant reduction, but, from what I've learned, there's a major difference in 34 degree curves and 25 degree curves.

[gerbo]

6 to 34, 6 to 25, it remains a big jump.......

[structural75]

skepticism abound...

GeorgiaMom,

Congratulations on your daughters progress... that's great news!

I'm sensing a tone of skepticism and negativity though coming from some others who have replied to this news. I don't recall any of you being this skeptical about the Montreal Drs. when Gerbo and Celia reported back that their children now have NEW SECONDARY curvatures after wearing the spinecor.??? Would you have been skeptical if those two children were under the care of a chiropractor and that happened... ? I think it's pretty safe to assume so.

I think second, third and fourth opinions are always a good idea. But at the end of the day, they're all still "opinions". I think the Montreal Drs are doing a good job, but when they find a new secondary curve being caused partially from the brace and dismiss it as being inconsequential.... well I have to wonder about them as well as all the others that get put down here.

It sounds like GeorgiaMom is doing well under the care of this chiropractor. A second opinion won't hurt any, but discouraging criticism about the chiropractor's methods/bracing time line may be a little preemptive.

[structural75]

Braceguy76,

Braceguy: As for you calling me a snake,I doubt you'd be saying that to my face or the next spine you heard crack would be yours.

No need for violent threats here! After all, you stereotyped his profession as snake-oil yourself. Whether you two agree on things or not, you can't help but understand how Sportsdoc could be upset at your highly slanderous remarks about his profession. He has every right to chime in and defend his livelihood. Your comments in previous posts were shared with many highly encourageable people on this forum. All it takes is one stranger, with his/her side of the story to tell to convince a lot of thirsty people looking for answers, justifications and security in the decisions they're making. Be careful about what you say and WHY you're saying it because it could personally effect many people involved, ...more than you might think.

You come from a field full of 'protocols', but the human condition seems to constantly defy protocols. We're not machines Braceguy76. Often our greatest achievements in medicine comes when we step outside of the box from limiting protocols and conventional thinking.

Albert Einstein once said, "The significant problems we have cannot be solved at the same level of thinking with which we created them."

I believe the protocols were set-up for several reasons... one being that it provides consistency for the spinecor study. I believe this is also part of the reason why the Drs in Montreal don't give the exercises to their patients that the spinecorporation recommends. When you add these kind of variables into the equation you face issues of varying degrees of compliance, which ultimately effects the accuracy and outcome of the study. It would no longer provide an accurate picture of the effects of the brace itself. But is it appropriate to limit the range of treatment strategies for these patients simply because of a "protocol" or a study? These MDs are depriving their patients of other useful compliments/adjuncts to wearing the brace for the name of 'science'. What about their health??? Doesn't the patients well-being and success trump a protocol or study?

Also, I find it interesting that you support insurance reimbursement for something that you yourself do not believe in 100%. Why should insurance companies pay for something that doesn't have substantial testing behind it (as you said yourself)? At the same time, you discredit the Medical practice of vestibular testing and rehab (adopted/utilized by these chiropractors) and ignorantly dismiss its potential relevance to scoliosis.??? I guess I can see how an orthotist would be viewing the body from a completely mechanistic standpoint. But the fact remains that scoliosis impacts and is sometimes caused by neurologic deficits. Although the testing is performed in part with the eyes, it is working through them as a reflection of inner ear/cerebellum functioning of primal coordinative reflexes and abilities. This is by no means far-fetched. And it may not have studies to prove its efficacy in regards to scoliosis yet, but it is anything but what you claim it to be.

If you want to approach this condition with mechanical devices alone, so be it, but leave the broader thinking folks alone.

I think we've seen what happens when we use a mechanical approach (ie bracing) all by itself. Secondary curves arise, rotations manifest, etc.... because you're just moving the strain in the tissue to another region of the spine, pelvis and body as a whole. The strain patterns that were previously holding the spine in its scoliotic curve may not be sidebending the spine as much anymore, but that doesn't mean it can't rotate, torque or compress the vertabrae. Something to consider.