| Brace
Fitting |
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In
the first visit, some evaluations are required
in order to fit the SpineCor® brace.
To help to perform
these evaluations, some anatomical points can
be mark on your back with a make-up pencil, which
will be erased at the end of the visit.
For all the evaluations, you will be asked to place your feet in a foot template
to avoid any influence of an eventual change of your position on the evaluations.
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| Evaluation |
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Then,
the following evaluations will be performed:
 Clinical
Evaluation - Evaluation will be
conducted on your growth pattern and
any postural abnormalities.
Radiological
Evaluation - A radiological study
is needed to evaluate the type of curve
and its potential of progression. The
x-rays required for this study are the
following:
- Frontal x-ray
- Lateral x-ray
- Supine x-ray (optional)
Note: All
x-rays used for this study should have
been done recently (a maximum of 1 month
old) in order to have accurate information
to evaluate the scoliosis curve.
The data
resulting from the clinical and radiological
exams are entered in the SpineCor Assistant
Software, which will provide information
to fit the brace correctly. |
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| Evaluation
in Brace |
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Once
the brace is fitted, it is necessary to evaluate
the effectiveness of the brace fitting performing
the following exams:
Clinical
Evaluation in Brace
Radiological
Evaluation in Brace - 1 new frontal
x-ray in brace is required to confirm the
result.
At the end
of the visit, all patients/parents will be
shown how to perform their specific Corrective
Movement and shown how to correctly fit the
brace, maintaining an optimal corrective
movement position, and how to take it off.
Patients/parents should demonstrate by fitting
the brace independently 2 – 3 times
that they fully understand the correct fitting
procedure. Each patient is provided with
a Patient Manual with the instructions to
fit the brace correctly and indications for
its correct maintenance.
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| Follow-up
Visits |
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Patients
will be asked to visit regularly their
bracing practitioner (doctor, orthotist
or therapist) along the duration of the
treatment for regular readjustments of
the brace and to control the evolution
of the curve. The frequency of the visits
and the evaluations to be performed are
as shown in the Standard SpineCor Protocol:
The table below gives a summary of the
basic evaluations and their frequency.
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1st
Visit
Brace Fitting
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2nd
Visit
1month after brace fitting
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3rd
Visit
3 months after brace fitting
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Following
visits every 3 months*
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| Verification of brace
as worn by the patient |
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X
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X
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X
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| Clinical evaluation |
X
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X
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X
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X
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| Frontal x-ray without
brace |
X
or x-rays < 1 month
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Decision by MD but
not normally necessary until brace weaning |
| Lateral x-ray without
brace |
X
or x-rays < 1 month
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Decision by MD according
to evolution |
| Supine x-ray without
brace |
X
Optional
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| Corrective Movement |
X
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X
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X
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X
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| Brace fitting / readjustment |
X
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X
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X
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X
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P/A x-ray with brace
(and shoe lift if prescribed)
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X
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X
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X
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Decision by MD but
normally each 6 months |
| Lateral x-ray with
brace (and shoe lift if prescribed) |
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X
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Decision by MD but
normally once per year |
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Follow-up visits after the first 3 months of
treatment are advised at 3 month intervals.
This review period may be extended to 4 or
5 months only in cases where the prescribing
doctor is confident that the progression risk
is low. Extended review periods are not advised
without great experience of SpineCor Treatment. |
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| Treatment
Duration |
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The
SpineCor® brace is worn for 20 hours per
day. The 4-hour out of the brace period should
be taken in two or more intervals during the
least active part of the day. The brace MUST be
worn while sleeping.
Average treatment duration for adolescent idiopathic scoliosis is 26 months.
Bracing is not weaned before the following criteria are satisfied:
1. Risser 4+
2. 24 months post menarche
3. Minimum brace wearing duration of 18 months
4. With Brace and Without Brace x-rays show the same or very similar Cobb angles
(5° or less difference)
Providing the above criteria are met, the patient should have developed a neuromuscular
integration of the corrective movement strategy to maintain a stabile curve.
Long term 5 year post treatment studies show 93% of cases do not increase their
Cobb angles from the point of weaning. |
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