Becoming a Patient at Scoliosis 3DC®
At Scoliosis 3DC®, we treat local and long-distance patients in our Schroth immersion program. For Boston area and New England patients, we recommend coming to see us for an initial examination, if possible. For long-distance patients wanting a comprehensive, effective, efficient Schroth program, (we teach patients from all over the United States and abroad) we start with a phone call. If you decide you have continued interest, we ask that you send a recent x-ray. If your interest is in Schroth immersion training and/or Schroth-compatible scoliosis bracing we offer a complimentary phone consultation with Dr. Moramarco or one of our Schroth therapists (who treat scoliosis or kyphosis–nothing else–all day long, each weekday). That way we can learn more about your/your child’s case and you can learn more about us and have your questions answered.
Before your consultation/first visit, please send the following to email@example.com:
X-rays: The x-ray views will depend on the case. As a guideline, at minimum, we require a recent Standing Scoliosis X-ray, PA view. This view shows the full spine taken from the back to the front. In some cases, it is best to have two views, known as a Standing Scoliosis Series, PA/Lateral. (That is two views of the full spine – the one from the back (PA) mentioned above, and also one from the side (Lateral). A lateral view x-ray is required for kyphosis patients and post-surgical scoliosis patients.
*Photos: 6 views for scoliosis patients (2 additional poses required for kyphosis patients – see below)
- Standing from behind
- Standing from the front (face not necessary).
- Standing – taken from the left side.
- Standing – taken from the right side.
- Standing from the front and back, while bending forward to show the spine. The patient stands hip-width apart, hands together (like diving into a pool) chin to chest with hands below knees, if possible, but not all the way to the floor.
- Kyphosis patients should also take forward bending photos from the left and right side so that the profile of the thoracic spine is visible.
*Girls/women should wear a sports bra or bathing suit top with exposure to the spine and athletic bottoms. Boys/men should be photographed without a shirt and wear athletic bottoms. These photos allow for postural analysis. Please see PDF for example.Postural Photos PDF
Medical History: Please include the patient’s full name, date of birth, and all available information pertaining to the scoliosis or kyphosis diagnosis. This includes the type of scoliosis (i.e. idiopathic, congenital, neuromuscular-if known), age at diagnosis, Cobb angle, Risser Sign-if known, family history of the condition (if any), approximate date of first menses (if applicable, for females) and all treatments and physicians seen for scoliosis or kyphosis. If the patient has had a spinal MRI, please obtain and share the radiologist’s report. Please be sure to list any other medical conditions, previous surgeries, and/or current medications.
Patient Forms: Prior to your first visit, please print and fill out our New Patient Forms.
We understand adolescents (and their parents) are busy people. We do our best to work with you to schedule a convenient time to bring your child for scoliosis program participation.
Understandably, most parents want to take advantage of school breaks for appointments, however, please consider that scoliosis doesn’t wait. Any growth potential your child has means that they may be at risk of scoliosis progression.
The best way to contact us for scheduling is by emailing firstname.lastname@example.org. If you have any questions, please don’t hesitate to call our office at (781) 938-8558. Dr. Moramarco also offers a complimentary phone consultation for patients and parents who have clinical questions.
What to Expect at Your First Visit
You will meet with Dr. Moramarco to review, in detail, the history of your or your child’s scoliosis considering age, type of curve, Cobb angle(s), health and family history. The comprehensive evaluation will include several scoliosis assessments and an explanation of your x-rays. The visit will also include a discussion about our scoliosis alternative treatments and they may apply to and benefit your situation, in particular.
- Visual inspection: observation of curve(s), shoulders, hips, head, pelvis, knees, ankles, and feet–from front, back and sides.
- Specific tests: range of motion, flexibility, scoliometer measurement, spirometry, chest expansion, palpation, muscle strength and gait analysis.
- X-ray review and an anatomy lesson focusing on your unique scoliosis. Many people think of scoliosis as just one or two curves. In reality, a primary scoliosis curve comes with counter curves above and below. Scoliosis is usually accompanied by trunk rotation and sometimes a change in the sagittal (side) profile–why it is referred to as a 3D condition–not just something you see on an x-ray!
- An overview of our comprehensive treatment options and Dr. Moramarco’s recommendation for you/your child.
Thank you for placing your trust in us. We look forward to helping you learn how to manage scoliosis and improve your quality of life!
Our 4-Day Bracing Process
For efficiency, we have streamlined the process of getting a scoliosis brace. When brace measurement takes place at the beginning of the week, we have the capability to manufacture and fit a brace with a four-day turnaround at Scoliosis 3DC®. This can be done alone or alongside a Schroth program, when scheduled accordingly.
The process begins with a quick and easy brace measurement appointment. Our team will take a 3D body scan (no radiation involved), manual measurements, and postural photos. These, along with a recent x-ray, are used for brace design. We create a custom scoliosis brace made to the patient’s exact specifications. Once the brace is fabricated, fittings begin. We will make individual adjustments to the brace for optimal comfort and correction. For patients who are not from the Boston area, this requires consecutive multi-day appointments. This is so that patients have an opportunity to wear and sleep in the brace and have follow-up appointments to ensure the best comfort and fit before returning home. Each individual fitting can be up to 1.5-2 hours long, but this can vary. We allow this much time because your/your child’s comfort in the brace is among our top priorities for scoliosis brace wearers.
Long-distance patients will need an in-brace x-ray (we typically send to a local facility that offers our patients a discounted rate or to Boston Children’s Hospital Radiology Department for EOS X-ray). This is done on the day prior to departure for two reasons: 1) to ensure optimal in-brace correction and to determine the preliminary in-brace correction effect. For local patients, we usually recommend having the x-ray after two or three weeks of the initial fitting. This is because the body will adapt to the brace over time. In-brace correction is patient-dependent. Some factors playing a role are spinal flexibility, type of scoliosis, Cobb angle at start of bracing, and stage of growth. We strive for at least 30-50% correction in brace. Some of our patients have achieved results in excess of this standard!
While in-brace correction is important, bracing for adolescent scoliosis requires a strict wearing schedule and compliance to treatment is necessary for the best possible outcome. Dr. Moramarco will go over instructions for wear (how many hours per day, estimated length of treatment) and care (how to clean the brace, situations when to take it off, etc.). We are proud to say that the vast majority of our patients are very compliant when it comes to brace wear. We attribute this to the education we offer and the care we take in fitting each brace, focusing on comfort.
Local patients as encouraged to follow up in person at regular intervals. Long-distance patients are also followed closely! Each out-of-area patient will receive a discharge packet with instructions outlining when to send updated postural photos (both in and out-of-brace) and height/weight updates. That way, our team watches to make sure the brace is fitting correctly over time. After we review the pictures and compare them to the pictures taken initially we provide feedback on progress, and most importantly, watch for any red flags to make sure each patient, no matter where they are from, receives the highest quality treatment over time. For long-distance patients, most brace adjustments can be addressed remotely–we’ve been managing brace wear successfully for patients from all over for nearly a decade. As long as the patient has not outgrown their brace (at which point, a new one will need to be made) we are able to guide you through the process.
Schroth Method Intensive Program
Dr. Moramarco will recommend a certain number of hours of instruction based on the specifics of your/your child’s case (age, curve severity, etc.). Most often, patients will do either a 12-hour or 17-hour program. These can usually be completed over the course of 3-5 days, depending on the individual.
Your stay will be action-packed – about 3-5 hours per day in the office with brief breaks built into the schedule. Patients with special considerations (i.e. considerable pain and/or learning and attention difficulties) can be accommodated with shorter sessions and a slightly longer stay if need be.
We firmly believe in intensive-style instruction as the best way to acquire the skills to combat scoliosis progression. It’s been done like this in Germany for nearly 100 years, for a reason. That said, local patients may opt to complete the Schroth program over 3-4 weeks if preferred.
During appointments, you/your child will most likely see Dr. Marc, Amy, and Kim over the course of treatment. We find our team approach on behalf of each patient works best. The three co-manage cases together. All three are personable and passionate about empowering people with scoliosis, whether the patient is a child, adolescent or adult! Schroth sessions are one-on-one with no other patients present. At this time, we offer group learning only for family members (i.e. siblings with scoliosis, or parent & child with scoliosis). Ask about that if you want to come with a family member who also has scoliosis.
Near the end of the program, we will narrate and film each patient’s entire program from start to finish. We’ll provide you with a digital link to your program and all the associated documents with explanations of exercises and annotated photos to have as a lifetime reference. As an additional resource, we also create a binder filled with detailed instructions and photos of each patient performing their exercises. The videos and written instructions can serve as a ‘scoliosis coach’ during independent practice until practicing alone is easy. Some patients use it regularly and practice along with the video. We also provide exercise checklists to help keep track of the routine to be done at home.
At Scoliosis 3DC®, we provide personalized treatment based on each patient’s individual case. The cost will be dependent on the recommended treatment plan (i.e. Schroth program, bracing, or combination treatment). Please contact us at email@example.com for pricing details and other inquiries.
Payment is accepted in the form of cash, checks, all major credit cards (Visa, MasterCard, American Express, Discover), FSA/HSA*, and pre-approved CareCredit funds (see below for more information about CareCredit).
*FSA/HSA: Please direct questions to your plan administrator.
CareCredit for Treatment and Care
We accept CareCredit – a card designed specifically for your healthcare needs. CareCredit can help you move forward with health care you see as necessary, with expenses not covered by your insurer. With low minimum monthly payment options, no up-front costs or prepayment penalties, you can obtain the care you want and need. Patients using CareCredit to pay for treatment must apply and obtain approval before arriving to the office. To apply now or to learn more about CareCredit, please visit CareCredit.com, or contact our office for additional information.
For other frequently asked questions, please see our FAQ page.Read Our Frequently Asked Questions