But the Canadian brace is not "too new" for two of the most prestigious children's orthopaedic hospitals in the U.S. The SpineCor is used at the renowned Shriners Hospital for Children in Erie, Penn., and at the famous Johns Hopkins Hospital in Baltimore, Md. Dr. Paul Sponseller at Johns Hopkins believes that the SpineCor brace "works for smaller curves, in patients who are very diligent about wear." Although Sponseller also said that some patients do not respond to any kind of bracing, he added, "I have had some noticeable successes as well, preventing surgery in patients who may well have needed it." Dr. James Sanders is the former chief of staff at Shriners and is now professor and chief of pediatric orthopaedics at Strong Memorial Hospital in Rochester, N.Y. "While I do like the theories of the SpineCor," he said, "it needs good testing to know if it is any more than just a nice-sounding theory." Both Sanders and Alman refer to studies now under way to determine if any of the braces currently in use really work.

Some experts believe the best chance of avoiding surgery is in diagnosing curves early. In the U.S., school screenings are done in many states. Girls are generally screened in the fifth and eighth grade, and boys in the eighth or ninth grade. The method used is the Adams forward-bending test: the child bends over to a 90-degree angle while the examiner, standing behind, compares both sides of the back, looking for asymmetry, like a protruding shoulder blade. When the child stands up straight, the screener can also check for unequal shoulders, or an uneven waist. If a problem is noted, the child is referred to a doctor. Canada has no such screenings in public schools.

Many doctors think school screening is a waste of time, since they don't believe there is an effective conservative treatment for scoliosis. Rivard disagrees. "I believe finding curves earlier, while they're smaller and treatable, will keep some children out of surgery." According to Rivard, fewer fusions are done in Europe due to their rehabilitative approach to scoliosis. "In Europe, the first line of defence for scoliosis is rehabilitative therapy. In Canada, the first referral is to a surgeon," he says.

At Sick Kids Hospital, Dr. Alman told me that scoliosis patients with curves too small for traditional treatment (under 25 to 30 degrees) are now routinely referred to the hospital's on-staff physiotherapist — but not for any active treatment. "Mainly to wait and watch and keep an eye on things," he said. Joe O'Brien, president of the National Scoliosis Foundation, is appalled at that. "I've never understood the logic of 'wait and watch,' " he told me indignantly. Also a supporter of school screening, O'Brien, who had his first scoliosis surgery at the age of 16, and four subsequent surgeries, said, "The only operation I regret was the first — it created all the problems that made the following surgeries necessary." O'Brien has three children with scoliosis and has managed to keep them all out of surgery: one using the SpineCor. Asked about the Quebec brace, he said, "It did what it was supposed to do [hold the curve and prevent surgery]."

SpineCor also did what it was supposed to do for Valerie Goulet, a second-year journalism student at Université de Montréal who was fitted with the brace at the age of 15 due to a painful 25-degree curve. She wore it the recommended 21 hours a day for 18 months, and said, "I didn't mind at all. I even had a boyfriend." Before being fitted with the SpineCor, Goulet had been told she might eventually need surgery. "And that I must wear a hard brace," she said. "I cried and cried." Long out of the brace, her curve is stable at only 12 degrees (anything under 10 degrees is so mild it's not even considered scoliosis). "I am so thankful that I met Dr. Rivard," she said.