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Publication

Unique and successful treatment principle and its application

The efficiency of the SpineCor brace was first exposed to the scientific community in 2002.

The results obtained with the first series of patients (n=55) treated by this flexible brace.

Dr. Coillard and the team of researchers noted that more than 87% patients had a real correction (>5º; n=22) or are stabilized (±5 º; n=26) in their Cobb angle after an average of 20 months treatment duration and 21 months after the end of bracing.

The quality of postural and cosmetic results obtained by this new non aggressive therapeutic approach was very surprising and promising.

The follow-up at the end of bracing for the first 55 AIS patients treated by the SpineCor brace enabled the authors to establish the first evaluation of the treatment principle and its application revealing a positive therapeutic effect.

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

Positive therapeutic outcome for AIS patients treated by the dynamic brace

The first survival analysis was performed in 2003 to assess success of treatment during the follow-up period of a group of 195 idiopathic scoliosis patients treated with the flexible brace. This initial cohort of patients (initial Cobb angles between 15 and 50º) reveals a positive treatment outcome; demonstrating a general trend of initial decrease in spinal curvature in brace, followed by a correction and/or stabilization at the end of treatment, which was maintained through 1, and 2 years’ post-treatment follow-up.

For the 29 patients who had a minimum follow-up of 2 years post-bracing, there was an overall correction greater than 5º for 55% of the patients, 38% had stabilization and 7% had worsening by more than 5º.

As reported by Montgomery and collaborators , a follow-up of 2 years is sufficient to foresee progression after weaning from the brace.

The SpineCor brace provides the opportunity to re-educate and maintain the neuromuscular control of spinal corrective movement through active bio-feedback.

Thereafter, it was now clear that the SpineCor system was no longer to be considered has an experimental brace but a true effective orthotic device for the treatment of AIS patients.

Coillard C, Leroux MA, Zabjek KF, Rivard CH. SpineCor – a non-rigid brace for the treatment of idiopathic scoliosis: post-treatment results. Eur Spine J 2003; 12:141-148.

Support of the SpineCor brace effectiveness in the treatment of AIS

In the year 2006, a survival analysis was carried out on a group of 365 AIS patients having agreed to be treated by the dynamic SpineCor brace.

The orthopedic treatment was a success for 84.6 % of the 120 patients having a minimal post-treatment follow-up of 1 year. The results were even more encouraging if one looks at the 26 patients having 5 years post-treatment follow-up: permanent correction in 65.4% of the cases, stabilization in 30.8% and only 3.8% progression of the curve.

This prospective study confirms that the SpineCor brace is effective for the treatment of AIS and tend to reveals a positive treatment outcome in the long run.

Vachon V, Coillard C, Zabjek KF, Rhalmi S, Rivard CH. (2006) [Survival analysis of a group of 365 idiopathic scoliosis patients treated with the Dynamic SpineCor Brace] Résonances Européennes du rachis.14(43):p. 1782-1786. French.

Sustainable correction and/or stabilization after the SpineCor brace discontinuation 

The SRS established in 2005 parameters for all future AIS bracing studies in order to be able to make comparison amongst more valid and reliable studies. Such guidelines allow promotion of the effectiveness of different braces using.

A group of researchers (Coillard, Vachon 2007) decided to evaluate the effectiveness of the SpineCor brace following the new standardized criteria proposed by the SRS.

249 patients fitted the criteria for inclusion as suggested by the SRS and 79 patients were still actively being treated. After all, 170 patients had a definitive outcome. Successful treatment (correction >5º or stabilization ±5º) was achieved in 101 patients of the 170 patients from the time of the fitting of the SpineCor brace to the point in which it was discontinued. Comparing the end of bracing Cobb angle to the one at 2 years post-bracing, this study revealed that the follow-up of orthopedic treatment was a success in 95.7 % of the patients.

The SpineCor brace is effective for the treatment of AIS supporting the previous papers. It is possible with the SpineCor brace to have sustainable correction or stabilization of scoliotic curves up to 2 years after discontinuation of brace treatment. This particular feature of the SpineCor brace makes it very unique and distinct to the already published literature on brace in which apparent correction obtained during treatment can be expected to be lost over time.

Richards BS, Bernstein RM, D'Amato CR, et al. Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine 2005;30:2068-2075.

Coillard C, Vachon V, Circo C, et al. Effectiveness of the SpineCor brace based on the new standardized criteria proposed by the S.R.S. for adolescent idiopathic scoliosis. Journal of Pediatric Orthopaedics 2007; Accepted for publication.

Gabos PG, Bojescul JA, Bowen JR, et al. Long-term follow-up of female patients with idiopathic scoliosis treated with the Wilmington orthosis. J Bone Joint Surg Am 2004;86-A:1891-1899.

                Bassett GS, Bunnell WP, MacEwen GD. Treatment of idiopathic scoliosis with the Wilmington brace. Results in patients with a twenty to thirty-nine-degree curve. J Bone Joint Surg Am 1986;68:602-605.

Positive outcome in AIS obese patients treated by the SpineCor brace

More and more children are becoming overweight in developed countries (Dehghan et al, 2005). Overweight patients with AIS will have greater curve progression and less successful results following the TLSO orthotic treatment than those who are not overweight.

503 consecutive patients treated using the SpineCor brace from one institution were analyzed, 190 patients were still actively being treated and 133 patients did not fit the research inclusion criteria proposed by the SRS. Finally, 180 patients have a definitive outcome in which 13 patients were considered to be overweight. The results of the study demonstrated that both overweight and normal AIS patients treated by the flexible brace had a positive outcome (62% and 66% of success respectively). We believe that SpineCor bracing is more successful in this cohort of patients since the application of dynamic corrective movements through the shoulders, thorax and pelvis is not adversely effected by excess subcutaneous tissue.  Rigid 3-point pressure orthotics in contrast cannot effectively apply forces to the spine of an overweight patient.

Dehghan, M., Akhtar-Danesh, N. and Merchant, A.T. Nutrition Journal. 4, 24-32, 2005.

O'Neill PJ, Karol LA, Shindle MK, Elerson EE, BrintzenhofeSzoc KM, Katz DE, Farmer Kw, Sponseller PD. Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am 2005; 87(5): 1069-1074.

Vachon V, Circo A, Coillard C, Rivard C.H. Positive outcome in overweight patients with adolescent idiopathic scoliosis treated by the SpineCor brace. Accepted to: The 12th World Congress of the International Society for Prosthetics and Orthotics, July 2007.