spinecor

[cherylplinder]

Sounds like maybe massage therapy would be cheaper and more effective for her neck spasms. I love a good massage.

[gerbo]

for all of us worried as to whether we are doing the right thing for our daughters/ sons; these 2 studies are as close as you'll get to a head to head comparison between hardbrace and spinecor

some comfort in the finding that outcomes in spinecor seem better!

i have the full articles, but haven't had time to read them yet, but will study them in detail over the weekend

gerbo

A Comparison of the Thoracolumbosacral Orthoses and Providence Orthosis in the Treatment of Adolescent Idiopathic Scoliosis: Results Using the New SRS Inclusion and Assessment Criteria for Bracing Studies.

Spine

Journal of Pediatric Orthopaedics. 27(4):369-374, June 2007.
Janicki, Joseph A. MD *+; Poe-Kochert, Connie RN, CNP *; Armstrong, Douglas G. MD *; Thompson, George H. MD *
Abstract:
This is a retrospective cohort study comparing the effectiveness of the thoracolumbosacral orthosis (TLSO) and the Providence orthosis in the treatment of adolescent idiopathic scoliosis (AIS) using the new Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management inclusion and assessment criteria for bracing studies. These new criteria will make future studies comparable and more valid and accurate.

Methods: We have used a custom TLSO (duration, 22 hours/day) and the Providence orthosis (duration, 8-10 hours/night) to control progressive AIS curves. Only 83 of 160 patients met the new SRS inclusion criteria: age of 10 years and older at initiation of bracing; initial curve of 25 to 40 degrees; Risser sign 0 to 2; female; premenarcheal or less than 1 year past menarche; and no previous treatment. There were 48 patients in the TLSO group and 35 in the Providence group. The new SRS assessment criteria of effectiveness included the percentage of patients who had 5 degrees or less and 6 degrees or more of curve progression at maturity, the percentage of patients whose curve progressed beyond 45 degrees, the percentage of patients who had surgery recommended or undertaken, and a minimum of 2 years of follow-up beyond maturity in those patients who were thought to have been successfully treated. All patients are evaluated regardless of compliance (intent to treat).

Results: There were no significant differences in age at brace initiation, initial primary curve magnitude, sex, or initial Risser sign between the 2 groups. In the TLSO group, only 7 patients (15%) did not progress (<=5 degrees), whereas 41 patients (85%) progressed by 6 degrees or more, including the 30 patients whose curves exceeded 45 degrees. Thirty-eight patients (79%) required surgery. In the Providence group, 11 patients (31%) did not progress, whereas 24 patients (69%) progressed by 6 degrees or more, including 15 patients whose curves exceeded 45 degrees. Twenty-one patients (60%) required surgery. However, when the initial curve at initiation of bracing was 25 to 35 degrees, the results improved. Five (15%) of 34 patients in the TLSO group and 10 (42%) of 24 patients in the Providence group did not progress, whereas 29 patients (85%) and 14 patients (58%), respectively, progressed by 6 degrees or more, and 26 patients (76%) and 11 patients (46%), respectively, required surgery.

Conclusions: Using the new SRS bracing criteria, the Providence orthosis was more effective for avoiding surgery and preventing curve progression when the primary initial curves at bracing was 35 degrees or less. However, the overall success of orthotic management for AIS in both groups was inferior to previous studies. Our results raise the question of the effectiveness of orthotic management in AIS and support the need for a multicenter, randomized study using these new criteria

and

Effectiveness of the SpineCor Brace Based on the New Standardized Criteria Proposed by the Scoliosis Research Society for Adolescent Idiopathic Scoliosis.

Spine

Journal of Pediatric Orthopaedics. 27(4):375-379, June 2007.
Coillard, Christine MD *; Vachon, Valerie MSc +; Circo, Alin B. MSc *; Beausejour, Marie MScA *; Rivard, Charles H. MD, FRCS(c), FAAOS, FACS *
Abstract:
The purpose of this prospective observational study was to evaluate the effectiveness of the Dynamic SpineCor brace for adolescent idiopathic scoliosis in accordance with the standardized criteria proposed by the Scoliosis Research Society Committee on Bracing and Nonoperative Management. They proposed these guidelines to make the comparison among studies more valid and reliable. From 1993 to 2006, 493 patients were treated using the SpineCor brace. Two hundred forty-nine patients met the criteria for inclusion, and 79 patients were still actively being treated. Overall, 170 patients have a definitive outcome. All girls were premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness included (1) percentage of patients who have 5 degrees or less curve progression, and percentage of patients who have 6 degrees or more progression; (2) percentage of patients who have been recommended/undergone surgery before skeletal maturity; (3) percentage of patients with curves exceeding 45 degrees at maturity (end of treatment); and (4) Two-year follow-up beyond maturity to determine the percentage of patients who subsequently underwent surgery. Successful treatment (correction, >5 degrees, or stabilization, +/-5 degrees) was achieved in 101 (59.4%) of the 170 patients from the time of the fitting of the SpineCor brace to the point in which it was discontinued. Thirty-nine immature patients (22.9%) required surgical fusion while receiving treatment. Two (1.2%) of 170 patients had curves exceeding 45 degrees at maturity. One mature patient (2.1%) required surgery within 2 years of follow-up beyond skeletal maturity. The conclusion drawn from these findings is that the SpineCor brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, positive outcomes are maintained after 2 years because 45 (95.7%) of 47 patients stabilized or corrected their end of bracing Cobb angle up to 2 years after bracing. Therapeutic study-investigating the results of treatment: level II.

[Celia]

Gosh I really miss all of you! I think I'm going stir crazy in the great outdoors . I have never seen so many shades of lobster on people in my life!!!! Dierdre is going on average 6 hours without the brace each day and I'm hoping this won't have a negative impact on our followup appointment in a few weeks.

[Mom37]

just a friendly hello!

Just wanted to say hello and thank all who have helped me through this journey. My daughter will have spinal fusion August 1st at Texas Scottish Rite Hospital for Children. I will try to post on the forum after when I can.

[MATJESNIC]

Mom37,

Good luck with your daughter's surgery. Please keep us posted. Please remind me of how old your daughter is and what her curves are. I remember you from a while back when we talked about the Spinecor. As you can see, my daughter is having her surgery a month after yours. Where do you live?

Celia, it is good to get away from the scoliosis topic for a while. Enjoy your vacation.

[structural75]

Christine2 and company,
I know most of you ridicule me and my opinion but here it is anyway.

Once again the parents on this forum have helped me to make a rational decision regarding the well being of my daughter and my wallet. After feed back from Gerbo and Cheryl and Karen, as well as my chiropractor and orthos I have decided that massage therapy will be the better choice to help with my daughter's muscle spasms. I do feel after re evaluating the last week and a half that I was miss lead as to the type of physical therapy that my daughter would be recieving. Thank goodness I caught it early (1evaluation and 1 session). I went into the PT's office asking for relief of muscle spasms not treatment for scoliosis. She is already being treated for scoliosis. After a lot of questioning I found that the PT was trying to change our course of treatment.

I understand what you're getting at but remember that the neck spasms are a symptom of the scoliosis... in other words 7 year olds don't typically get neck spasms without an underlaying cause/imbalance. So if anyone is to address your daughter's muscle spasms in the neck (a region of the spine that is attempting to adjust/orient itself to the 'corrected' curve below!!) they will need to understand the structural/tensional strain patterns that are coming up from below the neck and must be able to work intelligently and constructively with that or else they'll be potentially creating more problems. That is why I suggested in another thread to try utilizing something that has an understanding of these strain patterns, ...I wasn't suggesting to 'correct' or "cure" the scoliosis... but anyone working these side effects of the spinal and soft tissue imbalances (muscle spasms) should have an understanding of the scoliotic pattern contributing to it.

Trying to 'relax' muscles that are doing their best to adjust/maintain/balance the neck and head on top of a thoracic and lumbar scoliotic spine that has been forced into correction as dramatically as your daughters (congratulations by the way on your current success) is relatively futile. After the massage she will stand up and the head/neck will have to orient was again to the rest of the spine and the strain patterns will still exist... and her spasms will likely return until the next massage. So I think massage is precisely one of those things that could go on forever... constant 'maintenance' unless the strain in the soft tissue is address to balance it with the correction you've achieved below. That doesn't sound like a cheaper route to me. If you don't change the connective tissue tension, the spasms in the musclular fibers will probably continue.

I don't think I would be asking a massage therapist their "opinion" on my child's scoliosis or neck spasms as a result of it. They are not nearly qualified to give that sort of input.

p.s. - Contrary to your beliefs, I have never nor am currently suggesting anything to "cure" or "fix" her scoliosis. Just working intelligently and safely with your daughter's neck.

[cherylplinder]

As her body adjust to the new alignment of the spine, I think the problem will resolve. Her body will adjust eventually to the new straighter spine without "connective tissue" adjustments. That is why the 2 year post bracing studies show that the correction holds.
She could try the cheaper massage therapy and see if it is effective in relieving the neck spasms . From reading the studies Karen posted, cranial sacral therapy sounds like quackery to me. I really appreciate objective studies, myself. They are very helpful when deciding a course of therapy.

[structural75]

Christine,
Hold the phone... I wasn't attacking you... You know, I wouldn't have posted on this thread but when I was reading some of the recent posts from you all about this issue you brought up elsewhere, I saw that you folks are mentioning my name with the usual sarcasm and I wasn't even a part of your discussion. I don't appreciate being mocked or refered to in vein. So I felt inclined to clarify my response to you earlier on a different thread.

That's fine... I'm sorry that there isn't room for another perspective on this forum. Why ask a question if you know what the response is going to be from your friends and you don't care to hear some kind of sound reasoning for it? Despite the fact that you're searching for some sort of answer to these questions, or at least insight, it doesn't appear as though folks are very open to a larger and educated perspective. There would be no "can of worms" if we could actually have an intelligent discussion on these questions at hand. But instead certain folks always feel the need to dig into their 'database' for some kind of dirt on the topic to dismiss it as quickly as possible.... all the while convienently leaving out the "objective studies" that prove the validity of something. I'm sorry but that's depressing and rediculous behaviour when peoples well-being is on the line. If one doesn't have anything constructive, objective or posiive to say, then why contribute negativity on a topic they don't understand? ..other than to debunk it for personal reasons/hang-ups.

Cheryl,

As her body adjust to the new alignment of the spine, I think the problem will resolve. Her body will adjust eventually to the new straighter spine without "connective tissue" adjustments. That is why the 2 year post bracing studies show that the correction holds.

Connective tissue strain patterns do not resolve themselves following bracing... that is not why the curves sometimes hold. They hold because the bones were not allowed to deform during growth. Wait another 10 years and take a look to see if the curves have actually still held in the same exact place.... I think that you'll see they often don't remain as such... it just takes longer to progress slightly because the growth plates have ceased forming new bone and therefore boney deformity becomes a much slower process. But gravity remains a constant and the connective tissue will continue to resist its drag on the body... It will not magically disapear unfortunately. Maintenance is simply a reality with individuals with scoliosis... the amount needed will vary from one person to the next.

You can be wishful in the presumption that connective tissue work is unecessary, but the myriad of pain and problems people present here on this forum and beyond prove otherwise. You just end up with one compensatory pattern over another. I really don't see how my input on this is 'incorrect' and yours is accurate... ? ...Do you work with the human body in this context everyday... ? Do you not think that an experienced opinion is valid here? I really wish you would put aside your personal feelings about some previous dialogues I've been apart of and consider the perspective at least. You're limiting/discouraging potentially valuable options for many.

From reading the studies Karen posted, cranial sacral therapy sounds like quackery to me. I really appreciate objective studies, myself. They are very helpful when deciding a course of therapy.

Why didn't you read the myriad of other objective studies on cranial osteopathy? Since you're a fan of objective studies they might be of interest to you.... And give a more accurate unbiased picture. You can find dirt on just about anything if you look hard enough...

[cherylplinder]

You know, Structural, we don't know who or what you are? What are your credentials again? You certainly hold yourself up as an expert. We need to see some documentation.
You are regularly attacking members of the forum for communicating information. Gerbo and Karen both posted STUDIES that addressed Christine's questions. Christine read studies and formed her OWN opinion. She didn't just take the OPINION of a friend.
Although, since you don't consider the support factor of this forum something that you should be constrained by, you decided to deride her for her comment.
You should keep your OPINIONS to yourself. If you can't take the heat get out of the kitchen or keep your nasty opinions and attitude to yourself! You attack forum members on a regular basis and expect to be regarded with anything other than the ridicule you dish out?
Again- you don't have scoliosis and don't have a child with scoliosis and if you can't respect the needs of the parents on this forum for support, you should keep your promise and stop posting. Your attacks are cruel, not supportive and informative. It appears that you are the one that can't stand any opposition.
That is why I have a problem with you. The parents are smart enough to weed through any garbage anyone posts. But they don't need the cruel comments and tension you bring to the forum.

[structural75]

Cheryl,

...If you can't take the heat get out of the kitchen

Judging by my track record here on this forum with you all, and my persistance, I'd say I can handle the heat quite well... .

You know, Structural, we don't know who or what you are? What are your credentials again. You certainly hold yourself up as an expert. We need to see some documentation.

And yours? You seem to have no problem playing the role of expert when it comes to debunking things... Unfortunately you have never been able to back them up with any sort of anatomical/physiological understanding... . What were yours again? I think I've shown that I have a certain degree of knowledge and experience on these matters and am always willing to answer questions and comment with clarity of explanation behind my 'opinions' and thoughts. How about you?

You are regularly attacking members of the forum for communicating information. Gerbo and Karen both posted STUDIES that addressed Christine's questions. Christine read studies and formed her OWN opinion. She didn't just take the OPINION of a friend.

Who's attacking who? I've offered 'information' many times around only to be hastily attacked by people like you. And I was only presenting the 'other half' of the studies that Karen convienently left out. There were numerous objective studies done on the efficacy and use of cranial osteopathy from the National Library that Karen did not share with Christine. So if you folks are going to make it your purpose here to silence all methods that you're unfamiliar with then I will gladly present the other side. You folks are as bad as our politicians... nothing but smear tactics.

Although, since you don't consider the support factor of this forum something that you should be constrained by, you decided to deride her for her comment and post some of you psuedofacts that are not supported by any studies that you have bothered to post. You post studies, but not any that address all the mumbo jumbo that you spew!

Are you telling me that the studies Karen posted had anything to do with Christine's question? One of those studies was determining the increased effectiveness of acupuncture in combination with cranial work... ? What did that have to do with anything? The studies I posted on cranial Ost. were to show that it has been proven to be effective in treatment of a variety of conditions and that it does in fact alter the anatomy and physiology of the body. Which is very different than the conclusion Karen was attempting to draw about it based on the few selective studies she chose to post. By the way, can you prove to me that I'm offering "pseudofacts"? What makes them such? Is it maybe the fact that you are NOT the expert on these topics? What is wrong with offering information that you, or others, may not be aware of? I believe that these are my attempts at offering support... giving an educated opinion on matters that people are confused about. There is no harm in that. And just because this forum is also about support it doesn't mean you can spew off false and misleading information to people without being called on it. That's irresponsible and unethical.

You should keep your OPINIONS to yourself

Likewise, I don't remember you being an expert on connective tissue properties and manipulation. What are "connective tissue adjustments" anyway?

Cheryl, you seem to think that studies will supply us with all the answers.... So why are there so many people on this forum still asking so many questions? (repeatedly I might add)

[structural75]

Again- you don't have scoliosis and don't have a child with scoliosis and if you can't respect the needs of the parents on this forum for support, you should keep your promise and stop posting. Your attacks are cruel, not supportive and informative. It appears that you are the one that can't stand any opposition.
That is why I have a problem with you. The parents are smart enough to weed through any garbage anyone posts. But they don't need the cruel comments and tension you bring to the forum.

No I don't have a child with scoliosis, ...but I have a 5 year old neice with scoliosis and a 3 year old nephew with epilepsy... I think I can understand where you folks are coming from... And you may want to re-read my posts because they ARE IN FACT informative... whether YOU choose to listen and consider a different perspective than the ones you continuosly hear about is another story. Whether YOU are willing to gather ALL the information possible before making decisions is the real issue here. And apearantly you're not willing to do that. That's fine, limit yourself to studies and whatever else feels right... but unless you can respond to my "opinions" with something intelligable or constructive then leave me alone.

And it is you in fact who has essentially told me to shut up and bug off... in so many words repeatedly. I don't cast that kind of slander and negativity towards you and others... I believe it's you who can't handle another perspective/opinion/opposition from the norm.

"If you want different answers to the same questions you must start with a different premise."

[cherylplinder]

If you didn't continually attack parents for choosing a different avenue than what you propose, critique their treatment choices, and deride them for those choices in a cruel way, then I might believe that you gave one rip for the parents on this forum.
But you are hateful and unkind to parents making difficult decisions that they and their children will have to live with forever. You don't just stick to your "facts"

I would ban you if I could.

[RugbyLaura]

Hi all,

We have been away at my dad's for a week. The first time away with Immy's brace. It took some getting used to - not being able to be spontanious. Long walks along the seafront needed to be cut short due to rubbing & hours spent splashing in the sea or pool had to be timetabled. But we managed. It's difficult because everyone else is affected by the restrictions. Anyway, Imogen was in brace almost 20 hours a day without too much complaining. However, now we are home it's a different matter; without the prospect of a holiday to look forward to she's finding the reality of wearing her brace much harder to deal with. Lots of "it's not fair"s. And I agree, it's not - but it's life & you have to get on with it. Every time I look at her back it seems worse & I'm completely fed up with the whole thing!

Sorry for moaning - it's hard to keep a smile on your face, sometimes you've just got to let off steam and it helps to have the "ear" of others in the same situation.

Laura x

[emarismom]

Laura,

Sorry to hear that Immy is having a hard time coping. Hopefully, as time
goes on she will feel differently. Maybe at her three month appointment,
when her curve is much improved, she will see the value of it. Emily has not complained at all. However, we did go away to Busch Gardens and Adventure
Island (a theme park and water park here in Florida) a few days ago. On the day we were in the theme park, she wore the brace the 20 hours. Yet on the day we went to the water park she was out 8 hours. I felt so guilty about it!! It will be the ONLY time I ever do it. Prior to the trip I had her wear it for 22 hours each day and since we got back I have had her in it
22 hours a day. I hope it won't have any significant effect.

Also I just returned from Target where I found long, contoured t-shirts for under the brace. They were on clearance for $2.24 . Once we got home and tried one on they fit perfectly!! They are long so they go under the brace but on top of the underwear and prevent rubbing. Also the neck line is a little lower than any of the other shirts we have tried, so the brace and the undershirt are not showing at all!! YEAH!! I'm going to run over to another Target now to pick up all they have. If anyone one has a Target nearby you may want to go take a look.

[RugbyLaura]

Michelle, Thanks for the words of wisdom! I'm just feeling a bit sorry for her today as her dad (lovely man normally) shouted at her for not putting her brace on after dancing yesterday. She just forgot to & so was out of brace for about 3.5 hours, no big deal I felt as it was the only time she had out yesterday. But he was really cross.

Re underwear - Immy only wears the spinecor body suits. I have thought about trying nothing underneath when the weather gets really hot but wondered what to do about knickers (as we call them). Any suggestions?

Structural - just a suggestion - I value all constructive input from anyone, as I'm sure we all do. Perhaps, to avoid these arguments, you could start a new thread when you have a point to make and let us know about that thread. We could then read it if we wanted to...... Just a thought

Laura