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CLINICAL RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2019; 25: 754-759 DOI: 10.12659/MSM.912228 Received: Accepted: Published:

Effect of Preoperative SpineCor® Treatment on Surgical Outcome in Idiopathic Scoliosis: An Observational Study

2018.07.22 2018.10.15 2019.01.26

Authors’ Contribution: Study Design A Data Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G

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Corresponding Author: Source of support:

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Karina Rożek Barbara Jasiewicz

Department of Orthopedics and Rehabilitation, Jagiellonian University, Zakopane, Poland

Barbara Jasiewicz, e-mail: basiajasiewicz@gmail.com Funds from Jagiellonian University – research project No. K/DSC/003108

Idiopathic scoliosis is a three-dimensional deformity of the spine. We investigated the effect of preoperative treatment with SpineCor® dynamic brace on the efficiency of surgical correction from a posterior approach in adolescent idiopathic scoliosis.

This was a retrospective observational study. Participants were 53 girls who underwent surgery from posterior approach due to idiopathic adolescent scoliosis, divided into a study group (Group A, 27 girls) and a control group (Group B, 26 girls). Girls in the study group had previously undergone treatment with the SpineCor® brace. Outcome measures were amount of correction and coronal balance based on anteroposterior plain radiographs obtained prior to surgery, at 1 week after surgery, and at 12 months after surgery.

In both groups, satisfactory deformity correction was achieved after surgery (Group A, 73%±12 vs. Group B, 68%±16) and at 12-month follow-up (75%±12 vs. 68%±12, respectively), with no statistically significant differences identified. Directly after surgery, patients preoperatively treated with the SpineCor® brace displayed smaller coronal balance deviation compared with the preoperative measurement, with significant differences in the outcome achieved at 1 week after surgery in Group B. At 12-month follow-up, both groups had significant coronal balance improvement.

This is the first study assessing the effect of dynamic brace treatment on scoliosis surgery. The study shows that a history of preoperative treatment with the SpineCor® dynamic brace does not affect the amount of the achieved correction of AIS directly after surgery or at 12-month follow-up, but it does facilitate faster restoration of normal coronal balance.

Braces • Orthopedics • Postural Balance • Scoliosis https://www.medscimonit.com/abstract/index/idArt/912228

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THE SPINECOR BRACE IN THE TREATMENT OF SCOLIOSIS: THE PERTH EXPERIENCE *Kumar A, Crameri S, Chenik D, Woodland P, Dillon D Royal Perth Hospital, Perth, WA Australia INTRODUCTION Bracing is a generally accepted form of treatment for scoliosis in skeletally immature individuals with Cobb angle of more than 20 deg. The efficacy of bracing is rather more controversial, mainly due to issues with study design and methodology. Compliance is also a major concern with the rigid bracing systems such as the Boston brace. We present our experience with the SpineCor bracing system, which is a low profile system that is also less restrictive.

This dynamic system relies on the patients’ corrective movements and also offers rotational correction.

METHODS This is a retrospective case-note and radiological study with prospective data collection. Data collected include Risser scores, Cobb angles and conversion rates to rigid braces and to surgery. The SpineCor cohort is compared to a rigid brace cohort used as a historical case control series. All patients were treated in one institution by 2 surgeons and were under the care of 1 orthotist throughout their duration of treatment.

RESULTS A total of 29 patients have completed treatment with this brace at the time of this study. Risser score at start of treatment was 2 or less in almost all patients. Average time in brace was 16 months (4-38). Only 4 out of the 29 patients went on to progress by more than 5 deg (13.8%). 5 patients ended up requiring surgery (17.2%). 9 patients were converted to a rigid brace and 3 of these went on to have a surgical correction and fusion. The average correction in the group that was treated exclusively with the SpineCor brace was a decrease in Cobb angle of 5.6 deg (-26 to 8).

CONCLUSIONS Our progression rate of 13.8% compares favourably with the expected progression rate of 68% in this group. Our surgical conversion rate was also low at 17.2% - which compares favourably to the expected rate of 60%. Our control group, which was treated with a modified Boston type rigid brace showed a progression of more than 5 deg in 13 out of 32 patients (40.6%) and a surgical conversion rate of 11 patients (34.4%). We conclude that the SpineCor brace is an effective device for the brace management of scoliosis in a select group of patients. It is also potentially less restrictive and hence could encourage better compliance rates.

(Unpublished Paper - 2013)

SpineCor Peadiatric Treatment Results

Stud Health Technol Inform. 2012;176:379-82.

RESULTS OF SPINECOR DYNAMIC BRACING FOR IDIOPATHIC SCOLIOSIS Szwed A, Kołban M.

Source Department of Paediatric Orthopaedics and Traumatology, Pomeranian Medical University, Szczecin, Poland.

Abstract Background: Orthopedic bracing is used in conservative treatment of spinal curvatures. Apart from rigid braces, SpineCor dynamic braces with a flexible design have recently become available. The idea behind dynamic bracing is that derotational and correcting forces are transmitted via a system of corrective bands. The essence of this technique is maintenance of spine mobility while effecting a position in which all components of the three-plane deformity are corrected.The aim of this study is to evaluate early outcomes of SpineCor dynamic brace treatment for idiopathic scoliosis according to SRS methodology and criteria.

Material And Methods: The study group included 50 patients who were using SpineCor braces due to idiopathic scoliosis.

The indication for bracing was the finding of a >15° spinal curvature in skeletally immature patients (Risser grade 0-3). Correction or stabilization of the scoliosis (Cobb angle change of ±5°) were recognized as positive outcomes, while a negative outcome was defined as progression of the curve of more than 5° or to a value necessitating operative treatment. The study group was divided in to subgroups at enrollment, according to gender and degree of scoliosis.

Results: In the entire study group, correction was demonstrated in 24 patients (48%), stabilization in 14 (28%) and progression in spite of bracing occurred in 7 patients (14%). Five patients in the entire study group (10%) required operative treatment due to rapid curvature progression.

Conclusions: SpineCor bracing leads to stabilization of scoliosis in the majority of the patients. Introducing the SpineCor brace in patients with a scoliosis angle over 20° and Risser grade 0-3 very effectively prevented curve progression.

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adult treatment results Telephone: +44 (0)1246 455381

Email: info@spinecor.com

Website: www.spinecor.com

SpineCor Adult Treatment Results

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Scoliosis

BioMed Central

Open Access

Oral presentation

Adult scoliosis and the SPINECOR® dynamic brace: some early results on efficiency Louise Marcotte*1,2, Charles-Hilaire Rivard2 and Christine Coillard2 Address: 1Posturetek Inc., a private Chiropractic Practice, Montréal, Canada and 2Ste-Justine Hospital, Montréal, Canada * Corresponding author

from 5th International Conference on Conservative Management of Spinal Deformities Athens, Greece. 3–5 April 2008 Published: 15 January 2009 Scoliosis 2009, 4(Suppl 1):O56

doi:10.1186/1748-7161-4-S1-O56

<supplement> <title> <p>5^thInternational Conference on Conservative Management of Spinal Deformities</p> </title> <editor>Patrick Knott, Margaret King-Schumacher and Theodoros B Grivas</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1748-7161-3-S1-full.pdf">here</a>.</note> </supplement>

This abstract is available from: http://www.scoliosisjournal.com/content/4/S1/O56 © 2009 Marcotte et al; licensee BioMed Central Ltd.

Background

Scoliosis offers little hope for rehabilitation in the adult population. Pain and viscerosomatic dysfunction are frequently encountered. Conventional medical care uses rigid bracing, medication and surgery for the most serious cases.

Conclusion

These results suggest that the SpineCor® Dynamic Brace is a potential, promising conservative method for the treatment of scoliosis in the adult population. In this study, utilization of this brace improved patient pain and sense of wellbeing.

The treatment of adult scoliosis with the SpineCor® Dynamic Brace deserves more attention. This brace offers a variety of combinations to improve spinal alignment depending on the type, severity and rigidity of the curve.

The main therapeutic goal of this brace is to reduce the strain on the neuromusculoskeletal system. The brace acts as a dynamic support against compressive loading on the vertebral joints while creating a corrective movement in the spine.

Methods

Seventeen adult scoliosis patients aged between 21 and 69, whose curves had a Cobb angle 18 to 78 degrees, were fitted with a SpineCor® Dynamic Brace in a Chiropractic practice in Montréal, Canada. 13 of them were actively wearing it from 10 to 70 hrs per week.

Results

Thirteen of the 8 have complete resolution of their symptoms while in brace, 3 of which had a Numerical Pain Scale (NPS) over 6/10, and 2 had never experienced any pain before or after the treatment. It is important to make note that 8 of the 13 patients were concomitantly receiving CBP® Chiropractic care.

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Scoliosis

BioMed Central

Open Access

Oral presentation

A retrospective study of twenty-three adults treated for scoliosis using the Spinecor Orthosis Gary Deutchman*, Marc Lamantia, Joseph Indelacato and Marianna Raykhman Address: The Scoliosis Care Foundation, 1085 Park Ave, Suite 1E, New York, NY 10128, USA Email: Gary Deutchman* - info@scoliosiscare.org * Corresponding author

from 4th International Conference on Conservative Management of Spinal Deformities Boston, MA, USA. 13–16 May 2007 Published: 12 October 2007 Scoliosis 2007, 2(Suppl 1):S23

doi:10.1186/1748-7161-2-S1-S23

<supplement> www.biomedcentral.com/content/pdf/1748-7161-2-S1-info.pdf</url> <title> <p>4th International Conference on Conservative </supplement> Management of Spinal Deformities</p> </title> <sponsor> <note>Publication of these abstracts has been funded by the National Scoliosis Foundation (<url>http://www.scoliosis.org</url>) and the Asklepios Katharina Schroth, Spinal Deformities Rehabilitation Centre (<url>http://www.skoliose.com</url>)</note> </sponsor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1748-7161-2-S1-full.pdf">here</a>.</note> <url>http://

This abstract is available from: http://www.scoliosisjournal.com/content/2/S1/S23 © 2007 Deutchman et al; licensee BioMed Central Ltd.

Objective To determine if non-surgical treatment using the Spinecor brace can effectively reduce adult scoliosis curvature magnitude.

"Thoracolumbar" group (n = 3) had a mean average change of -6.0 degrees. The Lumbar group (n = 15) had a mean average change of -4.40 degrees.

Conclusion Study design Twenty-three adults between the ages eighteen and sixtyfive years, seeking treatment for adolescent onset idiopathic scoliosis (AIS) were fitted with the Spinecor Orthosis [1] after being exposed to an anterior-posterior (AP) full spine and lateral full spine radiograph, with a minimum of three months between exposures and a maximum of one year. Measurements of the radiographs were performed using a digital inclinometer in order to reduce error and all projections were exposed without the orthosis.

These findings suggest the use of a flexible strapping orthosis (Spinecor) is an effective tool in the management of adult scoliosis. Long term studies are necessary to determine the sustainability of these early positive results.

References 1.

Coillard C, Leroux MA, Badeaux J, Rivard CH: SPINECOR: a new therapeutic approach for idiopathic scoliosis. Stud Health Technol Inform 2002, 88:215-217.

Results Patients were separated into three groups based on curvature location: Thoracic (T), Thoracolumbar (TL) and Lumbar (L). T-tests were performed using the initial and follow-up Cobb measurements of AP radiographs for each of the three groups. The maximum (T) reduced from 94 degrees to 77 degrees (-12.2%) following a minimum of three months of treatment. The maximum (TL) measurement reduced from 31 degrees to 23 degrees (-13.4%), and the (L) minimum reduced from 17 degrees to 11.1 degrees (-15.3%). The patients in the "Thoracic" group (n = 20) had a mean average change of -5.27 degrees. The Page 1 of 1 (page number not for citation purposes)

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The experiences and effectiveness of the Spinecor brace on older adults with degenerative scoliosis: a mixed methods pilot study

J BETTANY-SALTIKOV1*, A PARK2, J LING2 Teesside University, Middlesbrough, UK, 2 School of Health Sciences and Wellbeing, University of Sunderland, UK Introduction: This paper details the qualitative experiences together with the quantitative effects of a mixed methods study into the SpineCor brace on older adults with degenerative scoliosis.

Objectives: The primary objective of this mixed methods study was to explore the qualitative experiences of wearing a Soft SpineCor brace in Older Adults (over 50 years old) with Degenerative Scoliosis. The secondary objective was to conduct a pilot study evaluating the quantitative effectiveness of the brace using different pain and quality of life questionnaires.

Methods: Participants: For the participants to be eligible for this part of the overall study, they were required to have worn the brace for 6-months (Figure 1). This time point was selected as it was believed by clinicians that it would be where the most noticeable changes in the patients’ health and pain scores would be observed. Furthermore, 6 months gave enough time for any initial teething problems with wearing the brace to be identified and resolved, as well as allowing the patients to reflect on their experiences of wearing the brace over a reasonable period of time. Due to significant problems with recruiting patients, only eight participants; 1 male and 7 female aged 55 and over participated in this study. Instrumentation: The spinecor brace used on the older adults was similar to the one used in young patients with adolescent idiopathic scoliosis reported in the literature. Procedure: All the participants were interviewed and completed the questionnaires. The data gathered from the interviews was then analysed using a top down approach with themes and subthemes being extracted.

Results and Discussion: The results showed that the main experiences of living with scoliosis in people over 50 was one of constant pain and limited activity levels. The interviews also identified the benefits patients experienced whilst wearing the brace along with the previously unknown functional problems associated with wearing the brace such as the comfort and practicalities of the brace design. As a result of the findings of this study, the SpineCor company changed the design of their brace to try to resolve the functional problems that the participants in this study experienced. The results from the quantitative questionnaires were compared with those from the control group who did not receive the SpineCor brace. Overall, we found that the patients who wore the brace, when interviewed, reported improvements in their pain and quality of life.

Conclusions and significance: The main experiences of living with scoliosis in people over 50 was one of constant pain and limited activity levels. The results suggest that the Spinecor brace is effective in reducing pain and improving the quality of life in older people with degenerative scoliosis. These preliminary results suggest that providing a soft brace to older people with degenerative scoliosis may help to decrease pain and improve quality of life.

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*

Corresponding author.

J Bettany-Saltikov et al. / The experiences and effectiveness of the Spinecor brace

Figure 1. AP view of a Soft SpineCor brace.

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