Can you describe the traditional scoliosis braces that are in existence right now?
The traditional braces that exist now are all spin-offs of a brace that was developed in the 1940s, called the Milwaukee brace. Adolescents had nightmares about this brace because of a chin piece and a headpiece that were very apparent. The modern developments of that brace, called TLSO braces, have the same degree of success as the Milwaukee Brace. The brace is worn from the axillary area down to the groin and under clothing, without any accessory pads or metal bars that stick out. It is made of a variety of materials but is usually hard plastic. It may be a very rigid polypropylene or less rigid, such as an orthoplast. There are many variations of the scoliosis brace, but essentially they’re just differences in modularity or material.
What are the benefits and drawbacks of the traditional brace?
Fortunately, it seems that most of the scoliosis braces have the same results. They’ve been shown to be effective in halting the progression of curvatures of the spine in kids who are immature in their spine growth. On average, 85 percent of treated patients can be treated successfully, i.e. preventing the curve from getting worse. The drawback is that it is a rigid brace and it interferes with activity. For a patient who is involved in dance or other sports, there is the need be out of the brace to be active. Most kids are in the brace from 16 to 22 hours a day depending on their age. Removing the brace for more time than recommended could compromise your result.
How is the Spine Cor brace different from traditional ones?
The Spine Cor brace involves a totally different concept in treatment. The more traditional brace is one in which we try to restore the alignment of the trunk and the spine in the hopes of keeping it from deforming further over time. Essentially, we are waiting for the soft tissues of the back to tighten with age. The Spine Cor brace was developed in Montreal on the basis of a neurologic and muscular approach to the treatment of scoliosis. The brace is a series of elasticized straps that are attached to a harness that’s worn under clothing and allows full motion. It fosters realignment of the spine but it doesn’t rigidly hold it in place. In the Montreal study, children were encouraged to be active.
So this can possibly correct it?
The traditional scoliosis brace is essentially a holding device and does not provide correction. The Montreal group has been using the Spine Cor brace five years. They have noticed those patients with curvatures of the spine less than thirty degrees have been demonstrating correction in spinal alignment and in the rib cage shape. With advancing scoliosis, ribs actually deform, and may make it difficult to comfortably breathe. The overall Montreal experience in the past five years is that for adolescents with idiopathic scoliosis, the Spine Cor brace works as well as existing scoliosis braces in holding the curvature from getting worse. Ongoing research involves immature individuals with scoliosis curves less than 30 degrees. This thesis involves intervention before true deformation of bone, cartilage and disc occurs. By encouraging realignment, it is believed that some degree of correction of spinal deformity can be achieved. We are one of the research sites involved in early treatment of scoliosis with the Spine Cor brace and have been involved for almost one year.
Can someone go from wearing a traditional brace to wearing a new one?
It’s conceivable, but we don’t have very much information about what the effect is of changing types of braces. If someone’s been in a traditional brace for a period of weeks, I don’t believe there would be any problem in changing to the Spine Cor brace. However, strict protocols are followed for the research population. All of the patients in the study group must be still growing, have scoliosis curves less than 30 degrees, and have no history of prior brace treatment.
What are the differences between the two braces? Can this one save money because it grows with the patient?
The traditional braces, by virtue of the fact that they’re rigid, are made specifically and customized in a sense to fit the child’s body. These braces are adapted and changed as the child grows taller and becomes heavier. Some braces last for nine to 12 months before they need to be changed. During an average course of treatment for idiopathic scoliosis in a young adolescent, I would expect to use three braces. The cost of the brace that’s offered by the Spine Cor company from Montreal is roughly half of the cost of the three braces that would be required. The brace consists of elastic straps and the cost of replacing the straps is very modest.