Spinecor Scoliosis Bracing for Adults

A new and innovative approach to spinal treatment in adults targets pain relief by providing postural rehabilitation and spinal offloading. Scoliosis in adults is typically the result of either having the disease as a child which has progressed to adulthood, or from the degenerative processes of abnormal aging. The scoliosis can be of any classification ( lumbar, thoracic, thoracolumbar, etc) and can result in chronic pain, leg discomfort, digestive, and lung complications.

Adults with
Scoliosis are now being successfully treated with the SpineCor Dynamic Scoliosis Brace. The goal of treatment in not to correct the adult scoliosis, as that is not possible with a brace, but rather to help support the spine and alleviate pain.

The new
SpineCor Pain Relief Back Brace is a neuro-muscular-skeletal rehabilitation tool for treating abnormal spinal loading and abnormal posture; it is not a simple back support brace.

Adutl Spinecor scoliosis brace treatment outcomes

During a two-year development process, the SpineCor Pain Relief Back Brace was clinically tested on over two hundred patients. A multi-centre retrospective case series investigating the efficacy of the SpineCor Pain Relief Back Brace in adult scoliosis patients suffering from back pain is now in progress.

Initial results from the first 26 patients fitting the inclusion criteria at twelve months follow-up demonstrated significant reduction in their numerical pain scores (NPS). 90% of patient’s achieved and maintained a mean pain reduction of 70%. In addition, patient’s achieved an average
Cobb angle reduction of 4.41 degree ranging from 12 degree to +3 degree. There was no statistically significant correlation between Cobb angle reduction and pain intensity.

Spinecor Adult Brace Treatment Objectives

1. Pain: The primary treatment objective of the SpineCor Pain Relief Back Brace is most often pain relief; however, postural improvement is directly related to pain relief and therefore should also be considered as a secondary objective.

Posture: Clinically appraised desirable postural changes will be patient specific and defined by both clinical and radiological features of their condition. Often, the posture changes seen, such as improvements in spinal decompensations, are responsible for stabilization or correction of progression and reductions in pain.

Progression: Correction/Stabilization of Spinal Deformities/Misalignments. In such cases, radiological evaluations are advised to optimize treatment. Radiological objectives may include optimization of spinal balance, reduction of spinal decompositions and reduction of Cobb angles. Please note significant correction of Cobb angles in adults will rarely be possible and therefore should not be the primary or only treatment objective.

Spinecor Adult BraceTreatment Principles

The new SpineCor Pain Relief Back Brace is a neuro-muscular-skeletal rehabilitation tool for treating abnormal spinal loading and abnormal posture; it is not a simple back support brace.

Modes of action:

Corrective movements gently guide the posture and spinal alignment in an optimal direction.

• The elastic corrective bands act to resist the body’s movement back to the abnormal position.

• This constant “correction, relaxation, correction, relaxation” is in reality a corrective postural exercise.

• The brace is able to put a patient’s body through 10’s of 1000’s of repetitions per day instead of the10-50 repetitions that are typical with other rehabilitation techniques.

• It creates
dynamic spinal offloading and neuromuscular rehabilitation with the ultimate goal of neuromuscular integration.

The Musculoskeletal Affects of Abnormal Posture and Spinal Alignment:

• Scoliosis and other
spinal conditions can affect the “balance” of body posture and spinal alignment.

• A loss of normal spinal balance creates abnormal loading on the vertebra, discs, ligaments, joints, tendons, muscles and nerves.

• Over a relatively short period of time, abnormal loads on the body tissues alter their functions.

• Over a long enough period of time the structure of body tissues will change in response to the abnormal loading further compromising function.

• These changes can damage the body .i.e. facet joint arthrosis, disc degeneration, mnerve root irritation, spinal stenosis, all of which lead to pain.

• Promoting a change in the balance of the posture and the
spine can help to correct the abnormal loading.

How does SpineCor compare to other braces?

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).

Practical tips on living with a brace

If your physician has recommended a brace you must understand that this is not an easy treatment method and does not replace the need for other treatments such as physical therapy. It is essential that you have a customized brace made which will fit your body shape. Everyone has a unique body shape, and particularly a patient with scoliosis will have a shape that requires detailed attention in the making of a brace.

There are many types of braces and your physician will determine which is most suitable for you. Initially, any brace will seem awkward to wear and may even be quite uncomfortable. To give bracing a fair chance be patient and get used to wearing your brace in a gradual manner. It may be a good idea to start wearing the brace for only an hour at a time and then increasing this daily until after a week or so you can tolerate the brace for most of the day. During bathing and while in bed the
brace can usually be removed, your physician will guide you in specific instructions.

How is Scoliosis evaluated?

An evaluation by a spine specialist is important when scoliosis is present. In addition to a comprehensive medical evaluation and examination, scoliosis is assessed by obtaining X-rays of the entire spine in the standing position. Scoliosis is confirmed when an X-ray reveals a lateral deviation (curve) measuring more than 10 degrees. In patients who have leg symptoms or difficulty walking, further tests may be ordered by your physician to more closely evaluate the spinal canal and the nerves which lead from the spine to the legs. This may require an MRI or CAT scan, and possibly a myelogram.

What is Adult Scoliosis?

The normal, healthy spine is straight when seen from the front or the back (frontal plane). When seen from the side, the healthy spine has several mild curvatures. By obtaining an X-ray of a standing person, the exact contour of the spine can be measured and then compared to normal values to determine if a significant spinal deformity is present. Scoliosis is defined as a lateral deviation of the spine. More precisely, if the spine, seen on an antero-posterior radiograph (abbreviated as "AP", ie. seen from the front), has a curvature that measures more than 10 degrees then a scoliosis is present.

When a curvature, or scoliosis, is mild then one may not be able to detect any abnormality without an
X-ray. On the other hand, moderate or severe scoliosis can be noted due to an asymmetry of the back. A tilted waistline and skin folds may be present, as well as a hunching, or protrusion of the back. Frequently, such an asymmetry in the back is more noticeable with leaning forward.

There are many
types of scoliosis, and people of all ages can be affected by scoliosis. In adults, scoliosis can result from several conditions, but most types fall into two different categories. In the first category is a person who had a scoliosis as a child/adolescent and the abnormal spine curve has increased into adult life or is becoming painful with aging. The second category of adult scoliosis is seen in patients who have never had a scoliosis as a child but begin to develop an abnormal curvature with aging. The spinal deformity in degenerative scoliosis is usually a mild side curvature involving predominantly the lower levels of the spine.

Symptoms related to
adult scoliosis are mostly due to degeneration (wear and tear) of structures that support the spine. These changes which are often called "arthritis of the spine" can occur at all levels of the back (neck, upper back and lower back). With aging and arthritis, a gradual narrowing of the discspaces between vertebrae, wearing out of the joints, as well as narrowing of the space available for the nerves (a condition known as stenosis) can develop. Although degeneration of the spine is part of the normal aging process in all people, it appears that in most people the spine becomes stiffer with age but does not develop a lot of abnormal curvature and causes only minimal or no pain. In other people the spine loses its structural stability with aging and gradually develops abnormal curvatures that can be painful and lead to symptoms including back pain, stooped posture, leg problems (numbness, heaviness, tingling, pain and weakness) and progressive difficulty in walking which requires frequent rests and activity limitation.

Is There Anything I Can I Do To Maximize The Benefits Of My Brace?

To give your brace the greatest chance of successfully stopping the progression of your spinal curve, it's important that you:

  • Wear your brace each day for the full amount of time your doctor prescribes.

  • Take good care of your skin daily.

  • Wear a well-fitting, wrinkle-free undershirt or undershirt/bra combination under your brace at all times.

  • Put on the brace exactly as instructed by your doctor.

  • Perform any daily exercises recommended by your doctor.

What Will I Be Able To Do While I'm Wearing My Brace?

Staying active is important and healthy! You should be able to continue to do anything you normally like to do, such as sports, playing an instrument or hanging out with your friends. Your brace may be removed while participating in your sports activity. Any activity you can do while wearing your brace should be okay, but if in doubt, check with your doctor first.

Why Do I Need To Wear A Brace?

The goal of bracing is to try and keep your curve from progressing. If the curve in your spine is more than 25 degrees and you still have a lot of growing to do, your scoliosis curvature could rapidly get worse.

Whether bracing actually works is controversial. Some clinical studies support the use of bracing in young patients whose curves are at risk of progressing. According to several studies conducted by the
Scoliosis Research Society (SRS), bracing successfully stops curve progression in 74% to 93% of female patients with idiopathic scoliosis, depending on the type of brace used and the duration of use1.

Because bracing is designed to
halt the progression of the curve, it's generally not recommended for treating scoliosis in young people who are skeletally mature or almost mature. Once skeletal growth has reached a certain point, or if the curve has become too severe (typically more than 40-50 degrees), bracing is generally not as effective. Bracing also is typically not recommended for treating adult scoliosis. Corrective surgery (spinal fusion with instrumentation) may be recommended in these instances.

Your doctor will determine if bracing is the
appropriate treatment for your spinal curve. If so, he or she also will decide which type of brace is appropriate and the length of time the brace should be worn. You and your parents should discuss your treatment and bracing options thoroughly with your doctor.

SpineCor Brace

It is the first and only truly dynamic brace, which provides a progressive correction of Idiopathic Scoliosis from 15 degree Cobb angles and above. Traditional rigid braces are non-dynamic and promote muscle atrophy.

It is the only brace that preserves normal body movement and growth and allows normal activities of daily living. In fact, patients with the
SpineCor brace are encouraged to be physically active while wearing the brace.

It can be worn comfortably and easily under clothing. This is particularly appreciated by younger patients, to whom
aesthetics are extremely important.

Its comfortable and non-visible nature leads to better patient compliance, particularly among children.
Greater compliance ( wearing the brace when they should ) leads to greater improvements in health.

Milwaukee Brace

The Milwaukee Brace is commonly used for high thoracic (mid-back) curves. It extends from the neck to the pelvis and consists of a specially contoured plastic pelvic girdle and a neck ring connected by metal bars in the front and the back of the brace. The metal bars help extend the length of the torso and the neck ring keeps the head centered over the pelvis. Pressure pads, strategically placed according to the patient's curve pattern, are attached to the metal bars with straps.

The Milwaukee Brace was the first modern brace designed for the treatment of scoliosis. Developed by Drs. Walter Blount and Albert Schmidt of the Medical College of Wisconsin and Milwaukee's Children's Hospital in 1945, its design has been tweaked through the years until reaching its current design around 1975. Today, the brace is used less frequently now that more
form-fitting plastic braces have been developed; however, it's still prescribed for some types of curves that are located very high in the spine.

Charleston Bending Brace

Another bracing option is the Charleston Bending Brace. Developed in 1979 by Dr. Frederick Reed and Ralph Hooper, the Charleston Bending Brace is worn only at night, which is why it's also known as a "part-time" brace

The Charleston
Bending Brace is molded to conform to the patient's body while he or she is bent towards the convexity—or outward bulge—of the curve, the concept behind this design being that it "over-corrects" the curve during the eight hours the brace is worn. The Charleston brace is typically recommended for spinal curves of 20-35 degrees, with the apex of the curve below the level of the shoulder blade.

Boston Brace

There are a variety of TLSO braces, but the one most commonly used to treat scoliosis is the "Boston Brace." TLSO braces are often called "low-profile" or "underarm" braces. They are not as large or bulky as the Milwaukee Brace (see below), and their plastic components are custom-molded to fit the patient's body.

Boston Brace extends from below the breast to the beginning of the pelvic area in the front and from below the shoulder blades to the tail bone in the back. This type of brace works by applying three-point pressure to the curve to prevent its progression. It forces the lumbar area to flex, which pushes in the abdomen and flattens the posterior lumbar curve. Strategically placed pads place pressure on the curve, and "relief voids" are located opposite the areas of pressure.

Developed in the early 1970s by Dr. John Hall and Mr. William Miller of The Boston Children's Hospital, the Boston Brace is typically prescribed for curves in the
lumbar (low-back) or thoraco-lumbar (mid- to low-back) sections of the spine.

The different types of braces for scoliosis

There are several different types of braces commonly used to treat the spinal curves associated with scoliosis. They include:

  • Boston Brace
    (Thoraco-Lumbo-Sacral-Orthosis "TLSO")

  • Charleston Bending Brace

  • The Providence Brace

  • SpineCor

  • The Wilmington Brace (TLSO)

  • Milwaukee Brace

What is a Scoliosis Brace?

If you have scoliosis with a spinal curve of about 25 to 40 degrees and are still growing, your doctor may recommend that you wear a brace. The purpose of wearing the brace is to keep the curve in your spine from getting worse as you continue to grow; however, it's usually not intended to reduce the amount of curve you already have.

There are several different kinds of braces commonly prescribed for
children and adolescents with scoliosis. Each is typically constructed of plastic and contoured specifically to your body, with strategically placed padding and straps that place resistance as needed on your particular spinal curve(s).

Recently a major breakthrough for alternative traditional hard braces has hit the market. The revolutionary soft brace, SpineCor , has been proven to re-educate the muscles. It can miraculously reduce, stabilize and often completely reverse a child's scoliosis.