In-brace correction is a key component of scoliosis bracing which plays a role in whether or not brace treatment is successful. Other factors, such as spinal flexibility, curve pattern, Risser sign, Cobb angle(s) degree at the time of bracing, and patient compliance also effect outcome.
In-brace correction of scoliosis varies by individual and can also be influenced by some of the previously-mentioned factors. The x-rays above demonstrate in-brace corrections of 64% in the thoracic spine and 50% in the lumbar spine in a 13-year-old adolescent girl with idiopathic scoliosis who is being treated at Scoliosis 3DC®. She is wearing the German-designed Gensingen Brace by Dr. Weiss.
This most recent evolution in Cheneau-style bracing provides adolescents the potential for improved results with scoliosis. This is because the Gensingen Brace strives to reduce curvature and improve posture in adolescents, rather than just halt progression.
When fitting patients with the Gensingen Brace, our goal is a minimum of 30% to 50% in-brace correction. Fortunately, many patients braced in the Gensingen Brace have achieved far superior in-brace corrections. For patients braced in the mild/low-moderate range (20º to 30º Cobb angle), or those with a particularly flexible spine, the goal is over-correction (meaning, the spine shifts in the opposite direction while in the brace). The better the in-brace correction, the better the potential for improved outcomes at brace weaning/skeletal maturity.
The Gensingen brace is also the first brace offering the potential to help manage severe scoliosis (50º or more). Typically, spinal surgeons begin recommending fusion surgery for growing children whose Cobb angles reach 45°-50° and often tell parents that surgery is the only option available to treat scoliosis at that level. In fact, the patient whose scoliosis x-rays are shown above was diagnosed with 50° thoracic curve and told that she should have surgery right away. Despite this recommendation, her parents brought her to Scoliosis 3DC® to complete an intensive Schroth Best Practice program and be fit with the Cheneau-Gensingen brace.
Now, in less than a year, her spinal curves measure 35° thoracic and 19° lumbar when out of brace for 24 hours. Since this past June, when she was fit with the Gensingen brace, she has grown 1” – meaning she has successfully managed scoliosis during a growth spurt. Her posture has also improved noticeably – proving that it is possible to effectively treat scoliosis without surgical intervention.
Other advantages of the Gensingen brace are that it has been designed for improved comfort. It has less material (with less coverage at the hip(s) and chest) which makes it more tolerable to wear and easier to conceal. This translates to fewer compliance issues for kids wearing this brace.
Each brace is a 3D brace and custom-designed by Dr. Weiss, third-generation Schroth family member, from his extensive CAD/CAM library compiled over his years as a conservative scoliosis expert. Patients and their parents can be confident that their child’s brace is 100% Schroth Method compatible and designed according to individual curve pattern. This means each brace is manufactured with the appropriate openings for Schroth rotational breathing, not just small air holes which serve no corrective function. Because the brace is 3 – dimensional, it addresses the 3 planes of scoliosis and aims to derotate the spine with each corrective breath – making postural improvement a possibility.
To help boost results, some families opt for curve-pattern-specific exercise as a supplement to bracing (such as the family of the girl featured in this blog). We like to think of our protocols as a one-two punch in the fight against scoliosis. We use the newest Schroth Best Practice protocols including Power Schroth, ADL training according to curve pattern, and exercises for the sagittal plane, as well as the traditional Schroth exercises made easy.
We are the only US facility to offer an intensive Schroth Best Practice program and the Gensingen Brace at one location. Over the course of a few days (usually five), your child can learn the most up-to-date techniques to fight scoliosis progression. 3D technology is what enables us to measure (by scan), design and have a brace manufactured within hours. The initial brace fitting can take place within 24 hours of a patient’s arrival in Boston. This means long wait times of three or four weeks are eliminated. This is important because when an adolescent is in the midst of a growth spurt, time is of the essence when treating scoliosis. Our approach is designed to help kids know the proactive steps they can take to avoid surgery.
We understand what families go through when a child is diagnosed with scoliosis because it happened to ours. We’ve made it our life’s work to learn the most effective management techniques and to bring those to others so they can control scoliosis and avoid progression. Managing scoliosis doesn’t need to be a mystery!
