1st Visit: Brace Fitting
In the 1st visit, some evaluations are required in order to fit the SpineCor® brace.
To help to perform these evaluations, some anatomical points can be mark on your back with a make-up pencil, which will be erased at the end of the visit.
For all the evaluations, you will be asked to place your feet in a foot template to avoid any influence of an eventual change of your position on the evaluations.
Then, the following evaluations will be performed:
1st. Clinical Evaluation: to evaluate your growth pattern and any postural abnormalities.
2nd. Radiological Evaluation: a radiological study is needed to evaluate the type of curve and its potential of progression. The x-rays required for this study are the following:
- Frontal x-ray
- Lateral x-ray
- Prone x-ray (optional)
Note: All x-rays used for evaluation should be less than one month old in order to have accurate information to evaluate the scoliosis curve. If x-rays are older than one month the films should be repeated on the day of the evaluation.
The data resulting from the clinical and radiological exams are entered in the SpineCor Assistant Software, which will provide information to fit the brace correctly.
Once the brace is fitted, it is necessary to evaluate the effectiveness of the brace fitting performing the following exams:
1st. Clinical Evaluation in Brace
2nd. Radiological Evaluation in Brace: 1 new frontal x-ray in brace is required to confirm the result.
(Note: This is to confirm a positive action of the brace and does not indicate the maximum correction, unlike rigid braces the SpineCor® brace provides slow progressive changes.)
At the end of the visit, all patients/parents will be shown how to perform their specific Corrective Movement and shown how to correctly fit the brace, maintaining an optimal corrective movement position, and how to take it off. Patients/parents should demonstrate by fitting the brace independently 2 – 3 times that they fully understand the correct fitting procedure. Each patient is provided with a Patient Manual with the instructions to fit the brace correctly and indications for its correct maintenance.
Follow-up Visits
Patients will be asked to visit regularly their bracing practitioner (doctor, orthotist or therapist) along the duration of the treatment for regular readjustments of the brace and to control effectively the progression of the curve. The frequency of the visits and the evaluations to be performed are as shown in the Standard SpineCor Protocol: The table below gives a summary of the basic evaluations and their frequency.
(Note: Protocols used in different clinics may vary, additionally the frequency of visits may vary for specific cases.)
|
1st VISIT Brace Fitting |
2nd VISIT 1 month after brace fitting |
3rd VISIT 3 months after brace fitting |
FOLLOWING VISITS every 3 months* |
|
|
Verification of the brace as worn by the patient |
X |
X |
X |
|
|
Clinical evaluation |
X |
X |
X |
X |
|
Frontal x-ray without brace |
X or x-rays < 1 month |
Decision by Physician according to evaluation but not normally necessary until brace weaning |
||
|
Lateral x-ray without brace |
X or x-rays < 1 month |
Decision by Physician according to evaluation |
||
|
Prone x-ray without brace |
X As clinically indicated |
|||
|
Corrective Movement |
X |
X |
X |
|
|
Brace fitting / readjustment |
X |
X |
X |
|
|
P/A x-ray with brace (and shoe lift if prescribed) |
X As clinically indicated |
X As clinically indicated |
X As clinically indicated |
X Decision by Physician according to evaluation but normally each 6 months, if clinically indicated |
|
Lateral x-ray with brace (and shoe lift if prescribed) |
X As clinically indicated |
X Decision by Physician according to evolution but normally once per year, if clinically indicated |
* Follow –up visits after the first 3 months of treatment are advised at 3 month intervals. This review period may be extended to 4 or 5 months only in cases where the prescribing doctor is confident that the progression risk is low. Extended review periods are not advised without great experience of SpineCor Treatment.
SpineCor Treatment
– The SpineCor® brace is worn for 20 hours per day. The 4-hour out of the brace period should be taken in two or more intervals during the least active part of the day. The brace MUST be worn while sleeping.
– The length of treatment will depend on the severity of the curve, age at start of treatment and its progression, but it is always a minimum of 18 months. (Average for adolescent scoliosis of 24 months, Juvenile cases require much longer treatment times.)
– To optimise the dynamic effect of the brace, patients are encouraged to perform any type of sport or activity WEARING the brace (except for swimming).
– A shoe lift may be also prescribed at the time of brace supply. All shoe lifts should be sole and heel, not just heel, and must be worn during all activities.
