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The Situation
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, 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. Because of a better understanding
of the risk associated and of the disease evolution, we have seen a shift towards
earlier treatment.
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Scoliosis Research
Findings
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, Perdriolle, William
P. Bunnell, Furster, Risser and many others.
This means that the earlier the scoliosis appears,
the greater the risks of evolution. Lonstein & Carlson
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 and other authors 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, Ponsetti and, in 1980, Guillaumat
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, Lonstein & Winter, Durand & Salanova
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.
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Drawbacks of
Rigid Braces
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.
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The Dawn of
Dynamic Brace
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°.
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SpineCor for
Scoliosis Treatment
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 are taking
two different approaches. We are comparing
it to the natural evolution of the disease
and to the existing braces. This is exactly
what we have been doing since 1995.
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