Scoliosis Bracing: Customization is Key


Recently, one of our star patients and her family revisited us from Ontario, Canada.  This time it was the youngest sister who required scoliosis bracing. Since 2014, when her oldest daughter was diagnosed very suddenly, the girls’ mom had been vigilant about watching her second daughter’s spine for signs of scoliosis.  For the youngest daughter in this family, Dr. Marc recommended nighttime scoliosis bracing. It’s important to be aware that scoliosis is a potentially heritable condition and when one child in the family is diagnosed, siblings should be monitored.

Just prior to their visit here, mom was convinced her youngest daughter was starting to show signs of scoliosis. She wasn’t taking any chances because the family was taken by surprise when an x-ray for pneumonia showed their oldest daughter had a scoliosis with a 47º Cobb angle.

Mom’s suspicions meant her youngest daughter would need an x-ray. When she asked their family doctor for an x-ray to confirm scoliosis, he refused to order it and dismissed her concerns. Mom was persistent though and approached a second doctor. He also expressed doubts but eventually relented. Mom turned out to be right. The x-ray showed scoliosis and Dr. #2 later conceded he apparently didn’t know much about the early indications of scoliosis.

Mom and dad sent us the x-ray and scheduled a Skype session with Dr. Marc. He recommended a Gensingen nighttime brace. The family came within a few weeks and during the third brace fit, the girls’ dad and I were talking when he said,  “you know, you really don’t emphasize the customization component of the brace enough on your website.” He went on to use the word “relentless” to describe Dr. Marc’s commitment for exacting brace fit. And he’s right; we want every braced patient as comfortable, and as corrected, as possible. We operate under the premise that comfort is all important because if a brace is intolerable kids won’t wear it. It’s been shown that a few hours a day of scoliosis bracing just isn’t enough.

Why is the Gensingen brace more tolerable than other scoliosis braces? For starters, it’s more lightweight than other braces. This is for two reasons. First, there is less material in the actual design. Dr. Weiss has eliminated one of the hips on each 3D Gensingen designed. When he did that a few years ago, it was a controversial move. Now, we’ve noticed others are suddenly following his lead. Another benefit of its design is that it does not compress the chest. That’s an an important distinction for developing girls. It’s also lighter because each U.S. made brace is manufactured from a modified polyethylene–sturdy, yet moldable. It’s why it can be easily adjusted for improved comfort.

People wonder how we help manage scoliosis bracing for kids from all over the U.S., Canada, and even for some kids from other continents. We do it by following patients closely through email, or we use Skype or FaceTime when necessary. Parents send us regular photo updates (we provide specific instructions on what is needed) and urged to keep track of growth. Managing scoliosis is an active process. When we get an email indicating a child is suddenly uncomfortable, it usually indicates growth may have occurred (in height or width) and an adjustment may be needed. Fortunately, with specific feedback from the patient we can provide instructions for the fix, or have the parents overnight us the brace so we can make the needed adjustments. It’s usually an easy remedy. When significant growth occurs, sometimes a new brace is needed.

The Gensingen brace differs from other braces for scoliosis in that it tries to take advantage of the growth process to improve spinal balance and stability, and improve posture. Whenever possible, the goal is to help patients attain some degree of curve correction. These objectives differ from the stated goals of conventional 2D braces where the objective is halted progression(1).

Earlier I mentioned that we consider the older sister of the patient in this post to be one of our star patients. This is because when the family first visited us in 2014 their older daughter presented with a Cobb angle of 62º. She had been diagnosed at 47º but by the time they arrived in Boston to see us 26 days after her initial diagnosis she had progressed 15º. “Big Sis” has been an incredibly compliant patient. She’s been faithful to her Schroth Best Practice program and reports wearing her Gensingen brace 21 hours+ per day. As a result of her hard work, at her last x-ray her curve measured around 30º.  She is currently deemed fully grown and has instructions to wean off her brace.

We can’t stress the value of choosing the right scoliosis brace and the benefits of fit customization by a caring practitioner (each Gensingen is designed according to the patient’s exact curve pattern and size). We strive to make your child’s scoliosis experience as easy as possible via the most up-to-date, non-surgical methods (and if you are an adult, we fit adult braces too!). The Gensingen brace is the most advanced evolution of Schroth compatible bracing technology available with a bracing library that is constantly updated.

While not all kids can expect the same results as our star patient; as a group, kids with curves of 35º or less with growth potential are experiencing very nice results. For patients with  curves of 30º and under, some have achieved improvements to Cobb angles of <10º–no longer scoliosis. It’s why it is our undying message is to urge parents to act earlier rather than later when scoliosis is diagnosed.

Our mission unknowingly began when we discovered our daughter had scoliosis. It didn’t take us long to conclude that kids and families deserved better treatment options–conservative options–in the context of a positive, caring environment. We set out to provide families a setting where each patient is able to attain their optimal potential for scoliosis improvement, self-sufficiency, and true hope. While some spinal surgeons continue to inform patients that scoliosis improvement is not possible without surgery, it’s been rewarding to see so many patients demonstrate results proving otherwise.

(1)Fayssoux RS, Cho RH, Herman MJ. A History of Bracing for Idiopathic Scoliosis in North America. Clinical Orthopaedics and Related Research. 2010;468(3):654-664.