1.  How does SpineCor compare to other braces?

1.  SpineCor is a dynamic non-rigid brace, meaning it is flexible. This important feature leads to numerous benefits:

  Preserves body movement and promotes corrective growth whilst continuing normal activities of daily living;

  Can be discreetly worn beneath patient's clothing for optimum self-image;

  Increases patient's acceptance for the treatment leading to optimal results;

  Over long-term offers a cost-effective solution to patient;

  Proven stability of treatment results after bracing discontinued, quite unlike rigid bracing;

  Clinical observation shows significant postural improvements

  No side effects (muscular atrophy).


2.  Is physical therapy beneficial?

2.  There is at this point in time no evidence to prove scientifically that physical therapy provided in conjunction with SpineCor provides any additional benefit, however, we do advise its use in certain cases. Physical therapy does have the potential to;

   Help mobilize the spine
   Reinforce the corrective movement
   Help with active self correction
   Help consolidate the corrective movement and gain a neuromuscular integration (stabilizing the curve)
   Speed up correction

All published data on SpineCor relates to treatment using the brace alone 20 hours out of 24 following our published treatment protocols. Whilst we cannot say variations to this protocol may not be positive we have no evidence to support such variations at this time.


3.  What is Vestibular testing for and how does it affect treatment?

3.  Vestibular testing is claimed to be useful in the evaluation of balance and central nervous system dysfunction. Because all scoliosis patients have some degree of abnormal posture and the vestibular system plays a part in the control of posture, vestibular tests on scoliosis patients always show abnormality. This abnormal vestibular function always improves naturally with use of the SpineCor brace as the patients posture improves. There is no evidence to suggest that specific vestibular rehabilitation exercises play any useful role. The SpineCorporation do not advise vestibular testing or rehabilitation exercises.


4.  Is chiropractic treatment helpful in conjunction with SpineCor treatment?
  
4.  We have no data to support the use of any specific Chiropractic care in conjunction with SpineCor treatment; however techniques which may mobilize hypo-mobile areas of the spine could be helpful.


5.  Why might my treatment fail?

5.  SpineCor treatment like any other treatment is not 100% effective even in ideal circumstances treatment will not be effective in 10 – 20% of cases. If you are unlucky enough to be at the highest risk of progression then your curve may still progress despite everyone’s best efforts. Some patients may have or perceive sub-optimal treatment for one or more of the following reasons:

   Failure to establish realistic expectations at the start of treatment.
   Failure to follow the SpineCor Protocols
   Complex atypical case
   Poor follow-up
   Poor compliance
   Poor physiological handling
   Loss of confidence in the treatment or doctor

It is important to understand that in most cases, treatment failures are attributable to the nature of idiopathic scoliosis itself and not the doctor, orthotist, patient or parent failing in some way. The broad range of severity and age of onset in idiopathic scoliosis put some patients at such high risk of progression that therapeutic success is not always possible by conservative non-surgical means.

Studies of different patient populations will show different results: the broader range of patients included in the earliest studies show a success rate of 89% in correcting or preventing progression. This group had more patients treated early (the optimal time for treatment success) and possibly some lower risk patients. The latest Scoliosis Research Society (SRS) defined study criteria (including only the highest progression risk patients and excluding early treatment cases less than 25 degrees) show a lower success rate of 60% in correcting or preventing progression, however, this compares to a 15% success rate for Boston type TLSO. Surgery rates in the SRS studies are 4 times less with SpineCor than Boston type TLSO braces.


6.  How many studies have been done to show the long-term effects of the brace?  

6.  Studies Clinical Studies are still ongoing and will continue for many years to come. At present, recently published data show excellent results with curve corrections stable at five years after treatment, a phenomena not typical of rigid bracing.


7.  What is the cost of the SpineCor brace?

7.  Individual treatment providers may charge differently for SpineCor treatment. To prevent excessive pricing, the maximum recommended retail price is published as $3,500 (€2,270 £1,750) which is for initial brace assessment, fitting and first follow-up. This figure does not include, the prescribing/referring doctor’s fees, x-rays, further follow-up/brace adjustment visits, replacement brace parts or any additional therapies (e.g. physical therapy or chiropractic care).


8.  Can the patient put the brace on him/herself?

8.  To begin with, patients need a prescription from a paediatric orthopaedic surgeon in order to obtain approval for treatment. Most of the time, patients are then referred to an orthotist / physical therapist who will set-up the SpineCor brace. Information is then provided to both the patient and his/her family on the use of SpineCor. It is easy for the patient to put it back on once it has been set-up and the bands numbered for fastening sequence and positions.


9.  What is the recommended daily use (in hours)?

9.  The daily recommended use in brace depends on the pathology of the patient, his/her age, progression rate and severity of the scoliosis. In general, it is recommended to wear SpineCor 20 hours per day.


10.  How do we go about washing the brace components?

10.  The maintenance of the brace is explained extensively to patients and their families from the moment that it is first applied. In addition, a maintenance guide explaining the washing and drying process of the brace is also provided to the patients when it is purchased.


11.  Who are the doctors involved with the brace?

11.  Dr Charles Hilaire Rivard and Dr Christine Coillard have dedicated over 12 years on research and the development of the SpineCor treatment system.


12.  Has any research been done on adults and SpineCor?

12.  As yet there are no published Scientific Studies but research is being carried out into the use of SpineCor for adults. Preliminary results look very positive.


13.  Can an adult be fitted with SpineCor?

13.  A US study is now evaluating the use of SpineCor treatment for adult patients. The treatment objectives for adults are quite different to children but the same principles of postural re-education through dynamic exercise and neuromuscular feed back still apply. Treatment objectives for adults are postural improvement and pain reduction. Whilst postural improvements may lead to very small Cobb angle reductions, true correction of scoliotic curves in adults is not possible and should never be the treatment objective. Early results with adults are very positive, with both postural improvements and pain reduction in all patients to date.


14.  Can the brace be used on an adult to reduce back pain?

14. Theoretically pain reduction in adults is possible, early treatment results do seem to support the hypothesis.


15.  Has any thought been given to eventually having an ''adult'' brace?

15. Yes, for the moment the size range of the paediatric brace has been expanded for adult use. In the near future a specific adult SpineCor postural rehabilitation brace (P.R.B.) will be launched.