We provide a full range of natural health services. Such as, full spine adjusting using main stream gentle methods as taught by Palmer Chiropractic University. Physical therapy to include things like ultrasound, electrical therapies, and exercise programs.

Full diagnostic procedures like x-ray, lab testing, MRI, and other specialized testing methods. We also do nutritional counseling to handle many disorders naturally and have a wide range of physician only Nutraceuticals in stock. Holistic examinations and treatment protocols.

The SpineCor system is a flexible brace that is principally prescribed for Idiopathic Scoliosis patients with a Cobb angle between 15° and 50° and Risser sign 0 to 3.  The brace is fitted on the patient in accordance to a sub-classification of the traditional SRS definition of curve types.  The SpineCor Assistant Software guides the treatment provider through the fitting process.  The brace is prescribed to be worn by the patients 20 out of 24 hours per day until they have reached maturity, with radiological evaluations performed prior to and immediately following the fitting of the brace, and every 4 to 6 months afterwards.  To accommodate for growth and postural changes, corrective bands need to be adjusted frequently and require replacement each 6-12 months for optimum brace performance.  Major brace components can last from 1.5 – 2 years.  A patient manual is provided that guides the patient in properly wearing the brace, as well as maintenance.  The SpineCor brace must only be fitted by a SpineCor accredited practitioner who has attended 4 days of intensive training and fitted a minimum number of patients under supervision.  It is also suggested that prescribing doctors attend some training in order to effectively monitor and manage this treatment using very different treatment principles and protocols.

INDICATIONS

The SpineCor System was designed, developed, and tested for the treatment of idiopathic scoliosis.  Its efficacy for treating neuromuscular, neurological and other types of scoliosis has not been evaluation and is generally contraindicated.
See SpineCor Indications and Contra-Indications for full details.

CONCEPT

The therapeutic approach is based on the etiology and pathogenesis of idiopathic scoliosis and uses a new treatment concept.  It is a pathology of the neuro-musculoskeletal system in growth and maturation.  The cause is genetic, and the pathogenesis involves a three-dimensional deformation of the spine, postural disorganization, unsynchronized growth and particular movement pattern of the body.

DIAGNOSIS

In order to obtain an accurate diagnosis, that would specify a particular class and subclass for the patient, the evaluation combines a clinical exam, radiological and postural evaluation.

TREATMENT

A specific corrective movement is performed, and the brace is applied according to the SpineCor Assistant Software instructions. The moderate tension in the elastic bands allows the repetition and amplification of the corrective movement as the child undertakes everyday activities. This results in a progressive curve reduction.  The brace is worn 20 hours out of 24. The four hours out of the brace must not be taken at once, usually the patient divides them into two breaks: morning and evening.  Sports are to be encouraged and done while wearing the brace.   To obtain a neuro-muscular integration of the new strategy of movement, the minimum duration of the treatment is 18 months.  Because of the progressive changes, absence of external support during the treatment, and intact muscles, there is no loss of correction after the brace discontinuation.  Physical therapy is NOT a necessity in the SpineCor program (SpineCor itself may be considered a physiotherapy 20 hours out of 24).  However, when the patient is willing to undergo a physio program, or a faster consolidation of the reduction of the curve is desired, the Global Postural Re-education (GPR) program is considered.  For the patients at the beginning of the treatment, the physio is carried out with the brace on; for the patients in the weaning period the exercises are done without the brace.

PROGNOSIS

To really change the natural progression of idiopathic scoliosis, it is essential to reduce the curvature enough to eliminate the negative impact of abnormal biomechanics and growth.  Therefore, it is possible to achieve a complete or almost complete correction of moderate curves, if the treatment is started before the main growth spurt (before Risser 1 and menarche).  In curves over 30 degrees of Cobb angle, or when the treatment started during or after the main growth spurt, the goal of the treatment is a stabilization of the deformity.  The therapeutic success is possible in more than 80% of cases.  The reference reducibility calculated as early as at 3/4 months of treatment, is useful in defining the prognosis.  However, for individual prognoses, the impact of the severity of the bone deformation, pattern of the growth and compliance must be considered.

Still, today, 80% of the scoliosis cases are known as idiopathic. Since the true cause is unknown, the treatment can only be based on the symptoms. Until now, only two types of treatment have been known to be efficient: the first is the treatment using an orthopaedic rigid brace ^{[2-4-7-8-19-21-22-23-31-32-33-35-36-42-46]}, and the second one is surgery with a spinal system.

In both cases, the therapeutic benefits can unfortunately be associated with non-negligible drawbacks that limit their uses ^{[1-3-5-10-28-29]}. Because of a better understanding of the risk associated and of the disease evolution, we have seen a shift towards earlier treatment.

The correlation between growth potential of the child, and, more specifically, of the adolescent, and the evolution of the scoliosis has been clearly established. It was demonstrated by Duval-Beaupère ^{[13-14-15-16-17]}, Perdriolle ^[37], William P. Bunnell ^[6], Furster ^[24], Risser ^[40] and many others ^{[inc. 34]}. This means that the earlier the scoliosis appears, the greater the risks of evolution. Lonstein & Carlson ^[30] analysed the natural evolution of scoliosis in a population of 729 adolescents. They concluded that a child with an angle between 20° and 29° and a Risser of 0,1 or 2, will see his/her scoliosis evolve in 68% of the cases. Stagnara and Clarisse ^[9-44] and other authors ^{[4-11-26-30-31]} have named the 30° limit “the critical limit” because, beyond this point, during high velocity growth periods, evolution of the disease is guaranteed.

Finally, the fact that the Cobb angle remained stable after maturity had been reached was challenged by Duriez ^[12], Ponsetti ^[38] and, in 1980, Guillaumat ^[26] shed some light on this: scoliosis with greater risk of evolution are the lumbar and thoraco-lumbar that have reached 30° or more at bone maturity. The thoracic and double scoliosis will evolve only if they have reached 60° at maturity. It does not mean that they are well accepted below 60°, especially from a cosmetic and sociological point of view. With this, it seems illogical to pretend that any 30° curve will remain stable after bone maturity is reached.

It has been established by Styblo ^[45], Lonstein & Winter ^[31], Durand & Salanova ^[11]that we can get much better results while treating small curves between 20° and 29°, compared with curves of 30° to 39°. A growing number of physicians have started treating scoliosis with an angle below 30º, hoping to get better results but also to break the evolution of the disease before it gets over 30º and becomes much more difficult to treat.

Despite some effectiveness, currently available braces, because of their rigidity, are damaging to a certain degree to the normal development of the neuro-musculo-skeletal system .

• Bone structures, especially the rib cage, have to stand significant mechanical constraints that can affect the harmonious growth process leading to some malformation and atrophy of mobile structures.
• Muscles are barely active and can only be maintained through a heavy physiotherapeutic treatment.
• Because of the pseudo-atrophy of the spine’s muscular system, it is not possible to guarantee that the correction obtained by the brace will be permanent.
• Finally the aesthetical results are generally poorly acceptable. In most cases, the adolescent prefers the cosmetic results following surgery in spite of the scars.

At the time period when orthopaedic treatment would have the best efficiency (i.e.idiopathic scoliosis of less then 30° for pre-adolescents), the drawbacks are major considering the consequences on an immature, evolving body. It is important to note that the existing brace’s main objective is to stop the disease’s progression. There are two reasons for this: first, there is no efficient corrective treatment that exists to this date; and second, it becomes more and more obvious today that it is extremely difficult to get a real correction, even partial, for a deformation beyond 30° since permanent vertebral deformations appear.

We can assume that early treatment can provide a better correction in a brace and that we can hope that this correction will be permanent. We believe that if one has efficient means to correct with none or limited drawbacks, the assumption of a true permanent correction would justify earlier therapeutic treatment with a minimum risk of over treating. The expected benefits justify a more aggressive therapeutic approach for curves smaller then 30°.

It is obvious to us that this means must be a dynamic one as we now better understand the relationship between the neurological, muscular and skeletal systems. It is also clear that not only must we not harm the neurological and muscular systems, but we need to use them to stabilize the spinal system. The spine curvature correction goal must not interfere with the goal of maintaining structural mobility and neuro-muscular control of the posture and movements.

In order to have better results in idiopathic scoliosis, early treatment while reducing or eliminating any drawbacks as well as using the neuro-muscular corrective potential, we have developed a new therapeutic tool based on an innovative approach. SpineCor the Dynamic Corrective Brace is the first and non-rigid brace which aimed at correcting scoliotic deformation through self-maintained correction of the neuro-musculo-skeletal system. SpineCor full potential is achieved with skeletally immature pre-adolescents with progressive idiopathic scoliosis of less than 30°.

SpineCor changes the dynamic of the trunk while harmonizing the posture. It is a therapeutic means with less mechanical constraints and an acceptable comfort level that preserves and enhances movements with a double therapeutic action:

• Progressive correction of the spine deformation up to the limit imposed by the pre-existing bone deformation.
• Neuro-muscular stimulation and correction.

The design of SpineCor happened through a scientific process based on decades of knowledge on scoliosis and its treatment. Therefore, we can be optimistic about its efficiency. To demonstrate and establish the real efficiency of this treatment about encouraging preliminary results, we can take two different approaches. We can compare it to the natural evolution of the disease or compare it to the existing braces. This is exactly what we have been doing since 1995.

To know more about our study, visit our Clinical Studies section.

SPINECOR SYSTEM INTERNATIONAL MULTICENTER STUDY

The first publication on SpineCor results was published in the European Spine Journal (Eur. Spine J. 2003;12(2):141-148) whilst the second was in 2006 in Resonances Européennes du Rachis (Aug 2006;43:1773-1781) on 365 patients.  The latest article, our third, was published in the Journal of Paediatric Orthopaedics in 2007 (J Pedia Orthop, Volume 27, Nr 4, June 2007: 375-379).

See Clinical Results page for more information.

Even though the effectiveness of the SpineCor brace is accepted world wide, we understand the necessity of collecting data from independent treatment centers to support the efficiency of the Dynamic SpineCor brace.

For this reason we are currently undertaking an International Multicenter Study, collecting results from independent SpineCor centers around the world, in order to reinforce those obtained at Sainte-Justine Hospital, upon which the effectiveness of the SpineCor brace is based.

If you are a SpineCor System prescriber or accredited professional and you are interested in taking part in this study, please contact us to receive the study protocol and detailed information about the project.

Latest Clinical Results – 2007

Clinical Results – 2006

Clinical Results – 2002

Treatment Approach

Scoliosis is a deformation of the spine which affects more than 5,7 million children around the world. Although to date there is no consensus on the etiology of Idiopathic Scoliosis, which accounts for 80% of cases, enough is known to allow better non-surgical treatments today.

Using modern knowledge along with that of years gone by, and safe, up-to-date technology, a multi-disciplinary team from Hôpital Sainte-Justine in Montreal has been addressing this problem. The team is led by Dr. Charles Hilaire Rivard, who is a paediatric orthopaedic surgeon, professor, and head of the Department of Surgery at the Université de Montréal. He, and Dr. Christine Coillard, a paediatric orthopaedic surgeon and Clinical Assistant Professor in the Department of Surgery at the Université de Montréal, have dedicated the last 12 years to the improvement of a non-rigid brace. Working in conjunction with The SpineCorporation to supply this unique brace world-wide, the team has developed a new, innovative treatment for scoliotic patients: the SpineCor System.

THE CONCEPT

Scoliosis is not only a deformation of the spinal column, it is also a disease of the neuro-musculo-skeletal system. If it progresses, it can have serious consequences for the patient. This complex system’s unstable balance during growth may, perhaps, be governed by the theory of chaos.

IDIOPATHIC SCOLIOSIS
TREATMENT
				Growth
Dysfunction		MINIMIZE		disharmony
Postural		REDUCE		Spinal
disorganization				deformation
SCOLIOSIS
	STABILIZE		REDUCE

Scoliosis is more than a 3D deformation of the spine. It also involves postural disorganization, neuro-musculoskeletal dysfunction and unsynchronized growth patterns all evolving with time. Using these four defining criteria, we can adopt a more specific approach to the static and dynamic properties of scoliosis that evolve over a period of time. Scoliosis is a four-dimensional deformation! Even though the etiology of scoliosis remains unknown in 80% of cases, technological progress and the creation of multi-disciplinary teams mean that, in addition to the spinal deformation, a child’s or adolescent’s morphological and postural abnormalities can be recognized, together with their dysfunction, growth and maturation problems. The therapeutic concept of the SpineCor System is closely related to the etiopathogenic concept. In keeping with this therapeutic concept, the design of this Dynamic Corrective Brace incorporates various independent, yet related, components.

It provides dynamic control of the shoulders and pelvic girdles and thorax, controls movement, and modifies the three-dimensional postural geometry. This allows us to correct the three-dimensional deformation while harmonizing the function and maintaining it over time. More harmonious growth patterns can thus be achieved. The SpineCor Dynamic Corrective Brace is prescribed by orthopaedists, who also monitor the treatment. It is suitable for all pre-adolescent or skeletally immature adolescents with early progressive idiopathic scoliosis, or in cases where the risk of progression is considered high. Early idiopathic scoliosis treatment will increase the chance of total correction and, therefore, reduce the bracing period. It can also be used as other braces with patients showing scoliosis with a Cobb angle between 31º and 50º with the objective of stabilization of the curve.

The conventional classification of idiopathic scoliosis is based on a radiological evaluation in the P/A view and different types are identified according to the position of the apex without any consideration of the sagittal view. This classification provides only partial information even though scoliosis is known as a three-dimensional deformation of the spine associated with postural disorganization.  When comparing x-rays among patients classified as the same, several differences in the morphological aspect of the curvature and other characteristics may be noted.  Clinically, the differences in posture for these patients are obvious enough to reconsider if they are indeed of the same type of scoliosis.  This has lead to the development of subclasses of the conventional classification of scoliosis patients.  A classification that reflects the three-dimensional deformation of the spine and the associated postural disorganization is therefore essential.

Observation of specific parameters, by combining frontal and sagittal x-rays, in order to get the maximum 3D information is involved.

• Tilt / rotation / version for each vertebra
• Tilt / rotation / version for the shoulder girdle / thorax / pelvic girdle
• P/A and lateral shift
• Modifications in the sagittal plane of the thoracic, thoracolumbar and lumbar segment
• Anteversion / retroversion / antepulsion / retropulsion

The dynamic corrective brace is made up of two components:

• The first component consists of the pelvic base, the crotch bands and the thigh bands. Its role is to act as an anchoring point and supportfor the actions applied to the patient’s trunk by the elastic bands.  When the pelvic base is stable, the traction by the elastic bands is provided along the stable lines.  The flexible nature of the pelvic section of the brace permits free movements of the trunk and engagement of the pelvis in the corrective movement.

• The second component consists of the bolero and the corrective elastic bands. Its function is directly related to the active principle of the dynamic corrective brace. It allows a custom fitting of the brace aimed at modifying the postural geometry of the moving spinal column.

The corrective elastic bands of different length allow for many possibilities in brace adjustment for an optimal correction.  Overall, there are 4 major ways to fit the corrective bands, corresponding to the thoracic, thoracolumbar, lumbar and double scoliosis.  The SpineCor Assistant Software provides the guidelines for the choice of the bands and snaps.

1. Adams W, Bunnell WP: Phychological effects of the Wilmongton brace in the treatment of scoliosis. Orthop Trans 13:91, 1989.
2. Bancel P, Kaelin A, Hall J et al: The Boston Brace: Results of a clinical and radiological study of 401 patients. Orthop Trans 8:33 -34, 1984.
3. Barois A, Bataille J: Retentissement cardio-respiratioire des cyphoscolioses, dans: Cahiers d’enseignement de la SOFCOT, 27-31, 1986.
4. Bassett GS, Bunnell WP, MacEwen GD: The treatment of idiopathic scoliosis with the Wilmington brace, results in patients with a 20-degree to 39-degree curve. J Bone Joint Surg 68A:602-605, 1986.
5. Berg U, Aaro S: Long-term effect of Boston brace treatment on renal function in patients with idiopathic scoliosis. Clin Orthop 180: 169-172, 1983.
6. Bunnell W. P.: The natural history of idiopathic scoliosis before skeletal maturity. Spine 11, 8: 773-776, 1986.
7. Canton J, Diana G, Jarousse Y, Mouillesseaux B. Picault C, Salanova C: Les orthèses, dans: Cahiers d’enseignement de la SOFCOT, 51-72, 1986.
8. Carr WA, Moe JH, Winter RB et al: Treatment of idiopathic scoliosis in the Milwaukee brace: Long-term results. J Bone Joint Surg 62A:599-612, 1980.
9. Clarisse P.: Pronostic évolutif des scolioses idiopathiques de 10° à 29° en période de croissance.: Thèse med. Lyon, 1974.
10. Collis DK, Ponseti IV: Long term follow-up of patients with diopathic scoliosis not treated surgically. J. Bone JointSurg. (AM), 1969, 51, 425.
11. Durand H, Salanova C: Brace treatment of adolescent idiopathic scoliosis, results in 477 patients (doctoral thesis). University of Toulouse, France, 1991.
12. Duriez J.: Évolution de la scoliose idiopathique chez l’adulte. Acta orthop. belg.,1967. 33, 547
13. Duval-Beaupère G: Examen, classification, évolution. In: La scoliose idiopathique, Cahiers d’enseignement de la SOFCOT, 13-24, 1986.
14. Duval-Beaupère G: Les lois d’évolutivité des scolioses. Application pratique. In: Réunion conjointe GES et SSQ. p. 115, Montréal, 1979.
15. Duval-Beaupère G: Les repères de maturation dans la surveillance des scolioses. Rev. Chir. orthop., 1970, 56.

Additional References

Coillard C, Rivard CH   Vertebral deformities and scoliosis European Spinal Journal, 1996,  5(2), p.91-100

Nguyen VH, Leroux MA, Badeaux J, Zabjek K, Coillard C, Rivard CH.Classification des scolioses thoraco-lombaires gauches selon leur morphologie radiologique et leur géométrie posturale.
Annales de chirurgie, 1998, 52(8): pp:752-760.

De la Huerta F, Leroux MA, Zabjek KF, Coillard C, Rivard CH. Évaluation stéréovidéographique de la géométrie posturale du sujet sain et scoliotique  Annales de chirurgie, 1998, 52(8): pp: 776-783.

Beaudoin L, Zabjek KF, Leroux MA, Coillard C, Rivard CH.   Acute systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects.  1999  European Spine Journal;8:40-45.

Zabjek KF, Simard G, Leroux MA, Coillard C, Rivard CH. Comparaison de la fidélité de deux systèmes d’acquisition 3D sur l’étude de paramètres anthropométriques et posturaux. Annales de Chirurgie 1999 53 (8) 751-760.

Coillard C, Leroux MA, Zabjek KF, Rivard CH. La réductibilité des scolioses idiopathiques dans le traitement orthopédique.  Annales de Chirurgie 1999 53 (8) 781-791.

Leroux MA, Zabjek K, Simard G, Badeaux J, Coillard C, Rivard CH.   A non-invasive anthropometric technique for measuring Kyphosis and Lordosis : an application for idiopathic scoliosis.  Spine 2000, 25 (13) : 1689-1694.

Griffet J, Leroux MA, Badeaux J, Coillard C, Zabjek KF, Rivard CH.   The relationship between gibbosity and Cobb angle for the treatment of idiopathic scoliosis.
European Spine Journal, 2000, 9(6); 516-522.

Zabjek KF, Leroux MA, Coillard C, Martinez X, Griffet J, Simard G, Rivard CH Acute postural adaptations induced by an orthopaedic shoe lift in idiopathic scoliosis patients.  European Spine Journal, 2001, 10;107-113.

Coillard C, Rivard C H. Etiology of idiopathic scoliosis :  an unsynchronized growth or why a system can turn chaotic European Spinal Resonances, 2001, 29; 1123- 1146.

Leroux MA, Zabjek K, Simard G, Coillard C, Rivard CH. Estimated kyphosis and lordosis changes at follow-up in patients with idiopathic scoliosis.
J Pediatr Orthop 2002 ;22(1):73-9.