The Sydney Scoliosis Clinic offers conservative, non-surgical scoliosis treatment options. It is important to note that in some cases, surgery may be the best treatment option and we work with doctors and orthopaedic surgeons to ensure the best results. However, conservative scoliosis treatments have the best result when the condition is detected early and treated with appropriate and proven methods.
In cases of Juvenile and Adolescent Idiopathic scoliosis, dynamic treatment such as the SpineCor brace has been shown to be an effective treatment in many of cases. Research reports that surgery can be avoided in over 75% of cases where the curve is between 20 and 45 degrees and the patient is still relatively young. For curves above 45 degrees, we recommend the Gomez Asymmetrical brace in combination with Schroth physiotherapy for the best outcomes.
Please note: It is NEVER too early to treat scoliosis. If your child has be diagnosed with a scoliosis and no treatment has been recommended, please contact us for a second opinion.
There are many types of scoliosis braces available, however based on the best research the Sydney Scoliosis Clinic recommends either the SpineCor scoliosis brace in cases where a soft scoliosis brace is appropriate, and the Gomez Asymmetrical TLSO scoliosis brace, in cases where a hard plastic brace is appropriate. The only method of determining which brace is suitable for each case is to have a thorough examination.
The SpineCor Brace
Research allowing comparison of the dynamic SpineCor brace1 to the hard Boston/TLSO2 was published in the Journal of Paediatric Orthopaedics in June 2007. Comparison of these two papers showed that the SpineCor scoliosis brace can be up to 4 times more effective at treating scoliosis than a TLSO.
SpineCor is a dynamic non-rigid brace, meaning it is flexible. This important leads to such benefits as:
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promotes corrective growth while allowing normal activities and exercise
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is barely visible under clothing, so helps with self-image
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because it is comfortable, patients are more likely to comply with treatment
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over the long-term offers a cost-effective solution
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proven stability of treatment results after bracing discontinued, unlike many rigid bracing methods
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clinical observation shows significant postural improvements
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no side effects (e.g. muscular atrophy which can occur with rigid bracing).
1) Effectiveness of the SpineCor Brace Based on the New Standardized Criteria Proposed by the Scoliosis Research Society for Adolescent Idiopathic Scoliosis Coillard C, Vachon V, Circo AB, Beausejour M, Rivard CH. J Pediatr Orthop. 2007 Jun; 27(4):375-379.
2) A comparison of the Thoracolumbosacral Orthosis and Providence Orthosis in the Treatment of Adolescent Idiopathic Scoliosis: Results using the New SRS Inclusion and Assessment Criteria for Bracing Studies. * Janicki J A, Poe-Kochert C, Armstrong DG, Thompson GH. J Pediatr Orthop. 2007 Jun; 27(4):369-374.
The Gomez Asymmetrical TLSO
The Gomez Asymmetrical TLSO was invented by Orthopaedic Surgeon; Miguel Gomez. This approach takes into consideration the postural alignment of the patient and the scoliosis deformity in 3 dimensions. Based on this 3 dimensional assessment and assessment of the patients flexibility, computer assisted design and manufacture (CAD-CAM) is used to produce a brace that attempts to correct the patients postural and spinal deformity in all 3 planes with a focus on overall spinal balance and stability.
Most rigid TLSO systems rely on traditional plaster casting of the patient and the x-ray. The use of CAD-CAM allows unlimited manipulation of the corrective brace in all 3 planes prior to production.
The Gomez Asymmetrical TLSO can be used for infantile, Juvenile and adolescent idiopathic scoliosis treatment. In some cases it can be used in non-idiopathic cases such as congenital and neuromuscular curves. The Gomez Asymmetrical TLSO can be used as a treatment in its on right, with physical therapy or as an initial treatment for larger curves with a view to switch to SpineCor bracing when the curve is more manageable.
The Gomez system as described is currently being utilized at Texas Children's Hospital in Houston Texas, the University of Oklahoma in Oklahoma City, Texas Scottish Rite Hospital in Dallas Texas, Children's Memorial Hospital in Chicago and now the Sydney Scoliosis Clinic.
For more information on the Gomez system of treatment in Australia please email or call the Sydney Scoliosis Clinic.
Physical Therapy and Exercise Programs
Specific scoliosis physiotherapy and scoliosis rehabilitation exercise programs can play an important role in scoliosis treatment.Traditionally most surgeons have been of the opinion that "physiotherapy does not work for scoliosis". While this maybe true for general physiotherapy or exercise used to try and stop progression of idiopathic scoliosis. The development of scoliosis specific programs such as the Schroth approach, offers a new role for physiotherapy in scoliosis treatment.
For example in a small adolescent idiopathic curve i.e. less than 20 degrees where there is a family history of scoliosis, a specific scoliosis physiotherapy program may be the most suitable initial treatment. Another example can be when a curve is non progressive i.e. in late adolescents or middle age. With Physiotherapy alone it maybe be possible to help improve posture, manage pain and stabilise the spine.
In cases of a progressive idiopathic scoliosis where the curve is greater than 20 degrees, physiotherapy is usually used in conjunction with brace treatments.
When specialised scoliosis physiotherapy has been used in conjunction with bracing it has improved the results of hard bracing. In this case the physiotherapy helps to strengthen the muscles being weakened by the brace and keep the spine flexible. When physical therapy is not used with hard bracing any correction achieved during the time of bracing is usually lost within 24 months of finishing brace treatment.
It is important to understand that only specialised physiotherapy and rehabilitation programs specifically designed to treat scoliosis, such as the SpineCor exercise program or the Schroth program, have been shown to make improvements.