Why I decided to brace my daughter with the SpineCor

[concerned dad]

We are all subject to Bias. Having made the decision to go with the SpineCor I am likely biased now. The trick is to recognize bias and account for it with good study design.
We would be foolish to think that orthopedic surgeons are not subject to bias too. I would submit that perhaps they are biased against the SpineCor because of the prevalence of chiropractors offering it as a treatment here in the US. As evidence of the potential bias I offer a couple of comments from the SRS website (buried deep on their website I might add). This is from an annotated bibliography put together by the SRS bracing commitee. I saw these a few weeks ago and wanted to share them with you (Sharon) because I though you would get a kick out of a few of their comments.
I'm not saying that the comments below are false, I just think that they hint at a bias. (Emphasis added is mine)

Chiropracty and Scoliosis:
Effects of chiropractic intervention on small scoliotic curves in younger subjects: a time-series cohort design. Lantz CA, Chen J. J Manipulative Physiol Ther 24:385-393, 2001.
These chiropractic authors report their negative results. These authors studied 42 patients age 6 to 12 years with curvatures between 6 and 25°. Each patients underwent a series of chiropractic full spine adjustment over a mean of 14.5 months. In addition, they also were given heel lifts, as well as postural lifestyle counseling and exercises, such as stretching on a chinning bar. No improvement in the curves was observed with this treatment. The authors concluded that chiropractic treatment does not improve scoliotic curves. An important study to quote when asked about the role of chiropractic intervention.

An inquiry into chiropractors’ intention to treat adolescent scoliosis: a telephone survey.
Feise, RJ. J Manipulative Physiol Ther 24:177-182, 2001.The author is Research Director, American Chiropractic Research Foundation. The findings exemplify the state of current chiropractic management of scoliosis. In this study 90% (114/216) of an eligible sample of chiropractors responded to a telephone survey to determine the clinical management approach to a hypothetical 12 year old, Risser 1, female patient with a 25° curvature of the spine. It was found that the typical chiropractor would provide 6 months of intensive adjustive treatment and 4 years of follow-up care, 73% would use heel lifts, 87% exercise, and 39% physical therapy or electrical stimulation (30%). Ninety-five percent stated that they used clinical experience as a means of establishing a treatment regimen. Only 20% knew the difference between retrospective and prospective research design.

I know you'll enjoy the last bolded text item. It doesnt prove my point but I just had to include it.

I guess my point is, after reading the above, how likely would it be that an orthopedic surgeon would refer a patient to a chiropractor to get a SPineCor brace? Now, of course, we realize that the chiropractors offering the SpineCor arent offering it as a 'traditional' chiropratic treatment (and the papers above are indeed relating to 'traditional' treatments).

[Pooka1]

Very amusing!

In re the presumably low likelihood of surgeons referring patients to chiros for Spinecor, I think that will be confounded by the number of surgeons who won't refer any patients for any type of brace.

There is a reason mainstream folks are skeptical of chiro. Not all chiro is woo-woo but much of it is.

[concerned dad]

OK, maybe not the best paper (understatement), but here is a recently published (last week) abstract by a presumably independent SpineCor researcher.
Sosort Abstract from folks in Greece

I need to dig into this "outcome" thing. It may mean all the patients in the study are still being braced. Or, it may mean that none of the patients have hit the 2 year post brace mark. <scratching head>

But in either event, it shows markedly different results than Weiss (who had 11 out of 12 patients progress in the SpineCor brace).

[Pooka1]

Something squirrelly about &quot;outcome&quot;



I realize that conference abstracts usually have tightly controlled word counts but they really should define "outcome" when it is their major result (since they stated it first). Also, as you state, it is very likely critical to understanding all the other results.

In this case, though, I think no outcome simply means the "magic" two year period hasn't expired to report the results per the 2005 SRS criteria. It's only been about a year.

Still, they could fill the void with data on how many patients are being treated versus weaned, etc.

[jillw]

Concerned dad, you are right aht they are still being braced because the opening statement said that they looked at patients that were still being actively treated - therefore the results aren't really that relevent, yet...hopefully they'll follow up in a few years as some of those patients reach maturity and post back to us.

[Pooka1]

I missed that.

So you are saying these are all "in brace" data?

That is not publishable in my opinion. By a LOOOOOOOOONG shot.

[mariaf]

I could not agree more with Sharon if in fact they are talking about "in brace" data. To me, it would seem premature to consider what "results" have been achieved if the treatment (i.e., bracing) is still ongoing.

[Pooka1]

I'm having another Candid Camera moment...

[CAmomof2]

The tactic of falsely attacking other modalities like surgery is a red flag... it is the IDENTICAL tactic young earth creationists use in trying to defend the counterfactual position that the earth is a few thousand years old. They largely attack, ineptly, the fact of evolution and the fact of radio-isotopic dating techniques rather than put forth positive evidence ruling out that the earth is old. The reason they have to do this is because the earth is in fact a few billion years old, evolution can be shown to be a fact (both from fossil and molecular evidence) and creationists have emotional reasons for denying these facts, not scientific ones.

When you take your playbook from the young-earth creationists, you know (or should know) you're in trouble.

Pooka,
Your above comment bothers me - I do believe in creation, yet I do NOT think that the earth is just a few thousand yrs old. The planet’s coming into existence is recounted in the Bible with the simple statement: “In the beginning God created the heavens and the earth.” (Ge 1:1) Just how long ago the starry heavens and the earth were created is not stated in the Bible. Therefore, there is no basis for Bible scholars to take issue with scientific calculations of the age of the planet. Scientists estimate the age of some rocks as being three and a half billion years, and the earth itself as being about four to four and a half billion or more years.
I'm not sure if this is what you meant - I just wanted to clarify this point. Sorry to others as this has nothing to do with scoliosis. Now... back to the program......

[Pooka1]

Very good point

I make every and all efforts to always use the term, "young earth creationist" to distinguish the counterfactual claims of a young earth with the unfalsifiable claim of "creation."

Young earth creationism is falsifiable and has been falsified a bazillion different ways for decades and decades. It is a demonstrable fact that the earth is a few billion years old and evolution is a fact.

I do realize rational folks use the term "creationist" to mean a non-literal rendition of biblical creation but not young earth creationism. That's fine but I just think they are running the risk of getting mixed up with the young-earth creationist crowd and should use a different term for their own sake.

If I used "creationist" instead of "young earth creationist," I was being sloppy and I apologize. "Creationism" distinct from "young earth creationism" is not falsifiable. It might be correct. But there is no evidence to date for the claim.

[leahdragonfly]

Can we please stick to the topic??

Hi Guys,

This is an interesting thread about bracing research, but can we PLEASE stick to the topic of scoliosis, and not get into the topic of personal religious beliefs etc. There was another long and contentious thread here some months ago about religion and creationism and we don't need to rehash it. Everyone gets to believe in what they believe in, and we should only be discussing scoliosis here.

Thank you.

[concerned dad]

Yes, there is a world of difference between the belief that God created the universe and the belief in the so called "science" of "Young Earth" Creationism.

Sharon was using it as a good example of a deceptive technique of arguing againt a point. And it is a good example of what she was trying to show. Perhaps there are others though as well because it can easily be misconstrued (Especially if you forget to add the words "Young Earth" and if people arent familiar with the notion that it is promoted as a science rather than a belief)

Going back to my diet example, it is as though Weiss was trying to show his diet was better then the SpineCor diet by pointing out the weakness of the SpineCor diet without demonstrating the effectiveness of his diet.

Hmmmm, not sure if that one worked. Weiss didnt do that here, he does it when he promotes Schroth over surgery. But I think Sharon's point was that this deceptive way of arguing is in his 'playbook".

And, for someone like myself who is now admitidly biased FOR the SpineCor, I am happy to see this Weiss paper discredited by way of discrediting Weiss. (Although to be honest, it is still a data point in the back of my mind).

But, regarding the "Candid Camera" thing.
Lets read between the lines a bit.

Weiss presents a paper where he says 11 out of 12 of his patients treated with the SpineCor failed during brace treatment. This Greece presentation, contradicts Weiss's claims, regardless of whether or not the folks are still wearing the brace.

This further discredits the Weiss study. Perhaps that was the whole point of the presentation.

And, they (the Greek folks) say, in their title, that this is a preliminary report.

[Pooka1]

(snip)But I think Sharon's point was that this deceptive way of arguing is in his 'playbook".

It is the fallacy of the false dichotomy. It is the attempt to claim overtly or subliminally that there are only two alternatives and if they can sufficiently attack one, then the other is left as the only possible "correct" answer.

It is obvious that this is the ONLY way to argue when there is no positive evidence in favor of one's position as is the case for young earth creationism and little positive evidence in favor in the case of Schroth.

[CAmomof2]

Pooka,
Excuse my ignorance - like I said I wasn't sure what you meant.

[Pooka1]

Pooka,
Excuse my ignorance - like I said I wasn't sure what you meant.

Ignorance?

You cleared up an important point.