Have any adults used the spinecore brace?

[tommyo]

Has it been effective for you? Does it relieve pain? How comfortable is it? How difficult to put on is it? Did Insurance cover the costs?

Thanks!

[orthotist]

spinecor

Tommyo,

The spinecor brace is designed for adolescent population and should not be used for adults, and, the results for its use even in this population are suspect.

Patrick

[Celia]

Hi Patrick,

Why is it suspect ? If you look at the literature on:
http://www.spinecorporation.com/English/index.htm
the results seem quite promising ! So... I don't understand your comment.




Celia

[orthotist]

spinecor

The results are from studies of children:

For example:
"For the two groups of patients the initial Risser sign was 0 for 86 and 45 patients, Risser 1 for 7 and 11 patients, Risser 2 for 12 and 7 patients, Risser 3 for 10 and 13 patients, and 2 patients with a Risser 4."

Case studies posted on site reflect treatment in adolescence.

Therefore, treatment for an adult is unsubstantianted. In regards to the existing studies, I still would like to see more long term results before I pass judgement.

One question - do the authors of those studies have any financial interest in SpineCorporation?

[LindaRacine]

Dr. Rivard, the inventor, did have a financial interest. Whether or not he still has a financial interest, I have no idea.

--Linda

[Celia]

Hi Patrick,

"I still would like to see more long term results before I pass judgement."

When you wrote "suspect" you were referring to the adolescent population and yes...you were passing judgement. If you read the scientific literature on the spinecorporation site under "papers" you will find an independent study "Experiences Gained With The SpineCor Dynamic Brace In Hungary" which again looks quite promising. I'm not here to criticize you, I just want to understand why there is such a negative perception in the medical community about the SpineCor brace. I don't care who has a vested financial interest in the brace, all I care is whether it really does work. Have you any experience with the SpineCor brace or are you aware of failed studies ?


Celia

[SandyC]

Celia,
You should be concerned with who has a financial interest. The reason you should be concerned is because if you buy into what every is being sold, in this case Spincore, it is the doc and his corp. that is going to finanually gain. So the more people that buy into it, the more $$$$ he/they make, never mind that it doesn't work It's kind of like a medical car salesman. In this case it is very much a "buyer beware"

[orthotist]

suspect

Celia,

This is forum for constructive discussion, and I view it only as constructive. Expressing my opinion is not passing judgement - I am very open to new ideas and am capable of changing my opinion, in my opinion.

It's coincidental that you refer to the independent "study" posted on the spinecor site. This "study" was a powerpoint presentation at a roundtable conference in spain that reviewed 18 cases. I have more confidence in peer reviewed, well controlled, large sample population type studies that are published in a respected medical journals. I say coincidental because two colleagues of mine were in attendance at that meeting in Barcelona. One of the major concerns of that presentation is that out of the 18 cases, 9 were cases with initial cobbs <= 20 degrees. Given the natural history literature, most physicians do not brace until the curve reaches 25 degrees with history of progression given that the risk of progression is low i.e. many of the curves potentially could have stabilized/not progressed in the absence of any treatment. That presentation reported 15 cases that either stabilized or improved, but, with just that variable in question, 9 of the 15 results are, and I will use that word again, suspect.

In regards to not caring about who has financial interest, well, you are entitled to that opinion. Personally, given that people who have a vested financial interest in the success of a given product that has (at least here in US) a large designated reimbursement involved in the published research about the product, well, it makes me wonder.

I have observed a fitting of the spinecor product by a local physician. I have read about it and examined it in booths at the national spine meetings. I have discussed the spinecor with colleagues - one published a 7 case review about it - http://www.oandp.org/jpo/library/2002_01_013.asp.

My opinion, I am suspicious and skeptical BUT, if a nice big independent well controlled study/ies come/s out that defines parameters and successes with the brace, I will listen and change my mind.

My three cents.

[Celia]

Patrick,

Thanks so much for your 3 cents, I really appreciate it.





Celia

[Celia]

Sandy,

I never thought of it that way. Dr. Rivard is a member of the Scoliosis Research Society and obiviously cares enough to develop a revolutionary brace to change the natural history of scoliosis. If someone develops a better mouse trap and profits from it, then who loses ? (the mouse obviously )


Patrick,


Conventional rigid braces leave much to be desired, often resulting in abdominal atrophy, rib cage compression and many times the best that can be hoped for is a pre-brace curve at the end of many years of bracing ! So why not embrace new methods if old methods are obviously inadequate ? Why is it taking so long to conduct independent control studies on the effectiveness of the SpineCor brace ? If there are failed studies, why isn't anyone letting us know ? Is there a brace out there that you really believe in - that makes your heart skip a beat ?




Celia

[LindaRacine]

Hi Celia...

While I think innovation is great, I think we should always be very careful when it comes to adopting unproved therapies as the "be all and end all." The published studies on the Spinecor brace look promising, but so have lots of other studies of products that have later been shown to be detrimental to one's health.

I'm not sure why, but some scoliosis specialists who initially signed up to provide the Spinecor brace to some of their patients, have gone back to the gold standard (Boston and Milwaukee) braces.

Since kids have a relatively short amount of time to have their curves halted, I think we (as consumers) should tread lightly, instead of blindly adopting a new and unproved therapy.

Regards,
Linda

[Celia]

Linda,

Thanks so much for your pearls of wisdom. I'm at a crossroads right now not knowing which brace to go with - I was considering the SpineCor and I even scheduled an appointment to see Dr. Rivard to discuss the possibility of going that route, but as you say it is very risky to blindly accept new untested treatments. Nevertheless we are going ahead with a mold for a rigid brace and hopefully everything will work itself out.




Celia

[Celia]

Hi,

Sorry for hijacking this discussion, I NOW know what my dilemma is ! Let's say my daughter's curve is stable at 15 - 20 degrees out of cast for a 24 hour period, what will the doctor say ? He'll probably say let's try part time bracing - first 12 hours without any support and if that works, six months with no support even though the curve is still above 10 degrees AND scoliosis by definition. So for us, the choice is not between a rigid brace and SpineCor but doing nothing and SpineCor ! Leaving a curve as is at 15 degrees and hoping to God that it doesn't increase with growth is not something I even want to consider because as you know it can get out of hand during growth spurts.

What do you all think ? Am I losing my mind ? Do I need a vacation ?





Celia

[LindaRacine]

Hi Celia...

My main argument against casting kids with very small curves was that it would be difficult to know what to do afterward, and until the child is skeletally mature. In other words, have her curve(s) remained small because that was their natural history, or because of the cast? <rhetorical question>

So, if you put your daughter into a Spinecor brace, and her curve remains stable for another year, what will you do then?

I'm actually surprised that insurance companies haven't stepped in to say they won't pay for braces for kids with curves under 25 degrees.

Regards,
Linda

[Celia]

Hi Celia...

So, if you put your daughter into a Spinecor brace, and her curve remains stable for another year, what will you do then?

I'm actually surprised that insurance companies haven't stepped in to say they won't pay for braces for kids with curves under 25 degrees.

Regards,
Linda

Linda,

I was hoping that the curve would resolve completely - but that's wishful thinking on my part. I don't know what the protocol is for curves that are stable at 15 degrees. Isn't better to do something rather than nothing ? Wouldn't we stand a better chance with something such as the SpineCor brace ? Given her age and potential for growth, anything can happen with her curve.

As for your second statement, once a curve progresses beyond 30 degrees it becomes very difficult to treat - I read somewhere that wedging occurs. I'm all for treating curves when they're small AND show signs of progression. The study that we discussed above underscores the importance of treating curves early.



Celia