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The first scoliosis brace attempts date back to as early as 400 A.D. and have been applied in every conceivable manner (without success) since then. The first metal scoliosis brace we constructed by Ambrose Pare in 1575 and again, didn’t work.  Ever since that time scoliosis patients have been search for alternative scoliosis treatments to braces.  Scoliosis brace makers have continued to innovate without success. Hard scoliosis brace, soft scoliosis brace, night time scoliosis brace, flexible scoliosis brace, rotational scoliosis brace, traction scoliosis brace; in the end each attempt has prove to be as feeble as the last (not due to lack of effort, application, or funding).

The main problem with scoliosis brace treatment isn’t application, but rather process. As it turns out, treating a condition that is primarily a neurological condition like it is primarily a skeletal spine problem doesn’t work too well (shocking….sarcasm). This very simple understanding of idiopathic scoliosis makes almost 3500 years of scoliosis brace treatment completely obsolete and practically worthless.
In fact, Axial Bio-Tech (developers of the Scoliscore genetic test) did a comparison study of brace treated and un-treated scoliosis patients and found absolutely no difference between the two groups long-term treatment outcomes, even when compared genetically. Scoliosis brace treatment has absolutely no effect on the natural course of the idiopathic scoliosis condition. Essentially scoliosis brace treatment and doing nothing have exactly the same effect….None.

So why do orthopedic doctors and some mis-guided chiropractors continue to prescribe a worthless and obsolete protocol like scoliosis brace treatment. Well the long answer is “this is the way we do things around here” syndrome and the short answer is financial gain.

Thousands of academic reputations and careers are based on the faulty logic that scoliosis brace treatment works and is effective, so to do an about face and reverse one’s position on the topic (even in the face of over-whelming evidence) would be career suicide for most.

The other motivation (financial gain) is a less complicated explanation, but probably more compelling. Scoliosis brace treatment generate hundreds of millions of dollars worldwide every year and you know what they stay about not finding the solution, when there is good money in prolonging the problem.
So how do we break out of this never-ending cycle of scoliosis brace treatment failure? Well, the good news is that we probably don’t have to; prognostic idiopathic scoliosis technology (Scoliscore genetic testing for idiopathic scoliosis, the scoliosis blood test, ect) will probably spell the death of scoliosis brace treatment all by itself.

These new technologies will provide a “heads up” to parents and patients in regards to their child’s idiopathic scoliosis condition and long before scoliosis brace treatment is indicated, so the scoliosis treatment market will naturally move towards more pro-active scoliosis treatment solutions like the Early Stage Scoliosis Intervention program we feature on this website. In fact, preliminary flowcharts and treatment models that focus on Scoliscore genetic testing for idiopathic scoliosis that completely eliminate scoliosis brace treatment and scoliosis surgery have already been developed and are being tested as you read this right now.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

The first scoliosis brace attempts date back to as early as 400 A.D. and have been applied in every conceivable manner (without success) since then.  The first metal scoliosis brace we constructed by Ambrose Pare in 1575 and again, didn’t work.  Since then scoliosis brace makers have continued to innovate without success.  Hard scoliosis brace, soft scoliosis brace, night time scoliosis brace, flexible scoliosis brace, rotational scoliosis brace, traction scoliosis brace; in the end each attempt has prove to be as feeble as the last (not due to lack of effort, application, or funding). 

The main problem with scoliosis brace treatment isn’t application, but rather process.  As it turns out, treating a condition that is primarily a neurological condition like it is primarily a skeletal spine problem doesn’t work too well (shocking….sarcasm).  This very simple understanding of idiopathic scoliosis makes almost 3500 years of scoliosis brace treatment completely obsolete and practically worthless.

In fact, Axial Bio-Tech (developers of the Scoliscore genetic test) did a comparison study of brace treated and un-treated scoliosis patients and found absolutely no difference between the two groups long-term treatment outcomes, even when compared genetically.  Scoliosis brace treatment has absolutely no effect on the natural course of the idiopathic scoliosis condition.  Essentially scoliosis brace treatment and doing nothing have exactly the same effect….None.

So why do orthopedic doctors and some mis-guided chiropractors continue to prescribe a worthless and obsolete protocol like scoliosis brace treatment.  Well the long answer is “this is the way we do things around here” syndrome and the short answer is financial gain.

Thousands of academic reputations and careers are based on the faulty logic that scoliosis brace treatment works and is effective, so to do an about face and reverse one’s position on the topic (even in the face of over-whelming evidence) would be career suicide for most. 

The other motivation (financial gain) is a less complicated explanation, but probably more compelling.  Scoliosis brace treatment generate hundreds of millions of dollars worldwide every year and you know what they stay about not finding the solution, when there is good money in prolonging the problem.

So how do we break out of this never-ending cycle of scoliosis brace treatment failure?  Well, the good news is that we probably don’t have to; prognostic idiopathic scoliosis technology (Scoliscore genetic testing for idiopathic scoliosis, the scoliosis blood test, ect) will probably spell the death of scoliosis brace treatment all by itself.

These new technologies will provide a “heads up” to parents and patients in regards to their child’s idiopathic scoliosis condition and long before scoliosis brace treatment is indicated, so the scoliosis treatment market will naturally move towards more pro-active scoliosis treatment solutions like the Early Stage Scoliosis Intervention program we feature on this website.  In fact, preliminary flowcharts and treatment models that focus on Scoliscore genetic testing for idiopathic scoliosis that completely eliminate scoliosis brace treatment and scoliosis surgery have already been developed and are being tested as you read this right now.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

I'm sure many of you have heard about the scoliscore genetic profile test from Axial biotech. My test kits have just arrived and I've finished going through all the literature.....overall, I think it could prove to be very useful in the context of early stage scoliosis intervention/treatment.

The parameters for the test are as follows....
-Caucasian decent (They tell me other ethnic profiles will be available soon)
-Ages 9-13 (the will test up to 14 or 15 years of age if the patient hasn't reached skeletal maturity)
-Cobb angle B/W 10-25 degrees

Basically, the test compares the patients genetic markers against 53 other markers that have been identified as high risk from the profile of 1000's of patients whose curves progressed beyond 40 degrees before skeletal maturity. The more marker matches to the profile the higher the risk.

The list price of the test is a right in line with other genetic tests ($2,900), but it is readily covered by insurance and they have financial assistance programs for those who qualify.

They claim the test is 99% accurate at determining whether or not the curvature will reach surgical threshold (40-45 degrees) while the patient is skeletally immature. That is all it measures. A 15 degree curve could still progress to a 39 degree curve with a low risk on the scoliscore test.

Here is the real pay off in my mind. Patients who have a low or intermediate risk according to scoliscore don't even need to see an orthopedist for their condition. Plus, just think of the anxiety it will reduce for patients and parents alike....AND the x-ray monitoring schedule can be completely re-thought for low/intermediate risk cases vs. high risk cases.

A non-high risk scoliscore patient can be managed entirely with an active rehab program during the condition's early stages to minimize and reduce the risk and effect of the condition on body image/disfigurement.

Early stage scoliosis detection and intervention = The DEATH OF SCOLIOSIS BRACE TREATMENT.

Only 1% (the high risk group) should even consider spinal bracing......and even that is most likely a waste of time.

So how do we keep Scoliscore from being utilized as a high-tech paperweight?

I must admit, I’m a little taken back by the level of resistance I’m seeing from much of the orthopedic community in regards to the use of the Scoliscore AIS prognostic test and how it will (or actually won’t) effect treatment decisions for early stage scoliosis patients. I’m even left scratching my head after watching the patient testimonial video on the www.scoliscore.com website entitled “Isabelle’s story”.

http://www.scoliscore.com/patient-re...0/Default.aspx

The patient (Isabelle) is diagnosed with early stage scoliosis and isn’t immediately tested with the Scoliscore test. Instead she is placed into the age old “watch & wait” mentality. The doctor only recommends the use of the Scoliscore test AFTER she has experienced a “big curve increase” following a growth spurt! They immediately put her in a rigid brace (again, following the same old AIS treatment protocol) before determining her genetic risk for progression with the Scoliscore test.

The test results come back and she has a Scoliscore of 16 (very low genetic risk for curve progression to a surgical level), which begs the question…..So then why did she experience the “big curve increase” following the growth spurt? I mean, it’s great that she has a low genetic risk for developing a severe curvature (40+ degrees), but the “big curve increase” during the growth spurt was certainly less than optimal or desirable. She obviously has a very high environmental factors risk that is going completely unaddressed (and will continue to be unaddressed in the rigid brace they prescribed to her in the video). Incredibility enough, at the end of the video they in a large part use the genetic risk factor evaluation in the decision to discontinue ANY forum of treatment in Isabelle’s case, so she can go off to summer camp, without the brace (which probably wouldn’t have helped anyway since it doesn’t reduce or eliminate the environmental risk factors that are obviously driving her curve progression to this point), so she can engage in dance and swimming……Two known high risk activities for AIS patients! Ahhh!

This just goes to show that the most incredible technological advancements can be defeated by incompetence or an unwillingness to adapt to change.

I can’t tell you have many conversations I have with colleagues of mine (within the CLEAR Institute even!) and orthopedic scoliosis specialists who have a SERIOUS case of the “that’s the way we do things around here” syndrome in regards to adapting their treatment plans in accordance with the vast advantage the information from the Scoliscore test provides. They look at me and say, “well, it’s certainly nice information to have, but it isn’t going to change my treatment plan in anyway.” WHAT!?! I respond back to them with “so your planning on treating a AIS patient with a Scoliscore of 200 (the highest level) exactly the same as a AIS patient with a Scoliscore of 20 (very low genetic risk)?” A blank stare is the only response I have gotten from anyone to this point.

Think about it in a metaphoric sense. Would you react differently if you saw a child standing 20 feet off the rail road tracks as a train was bearing down on them, than a child standing ON THE TRACKS as the rail rolled towards them? I would certainly hope so. Neither case is ideal, but the two situations certainly warrant different responses.

The Scoliscore AIS prognostic genetic test will serve the patient about as much as a high tech paperweight if it isn’t utilized (in conjunction with evaluation of environmental risk factors…not the end result factors….Aka: Cobb angle) to fundamentally change the patient’s treatment plan and/or treatment options.

I think Helen Keller said it best: “The only thing worse than blindness is a person with no vision.”

The traditional cobb angle directed treatment plan attempts to solve the AIS problem without knowing the genetic risk or environmental risks of the patient, so every patient with similar cobb angles are treated the same reactionary way until it is too late and the curve progresses. That is why we have developed an alternative Scoliscore directed treatment plan in which the treatment plan and follow-up evaluations are personalized according to the patient’s individual genetic and environmental risk factors. The alternative pathway also provides 100% of high risk patients the opportunity to utilize guided bone growth type treatment strategies, if deemed necessary, (as well as environmental factor reduction strategies) to the most beneficial degree possible.
Scoliscore testing and reduction/elimination of environmental factors in the early stage of AIS can finally give us the power to alter the natural course of the condition and honestly tell AIS patients that we are working towards an actual “cure” for the first time.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.

Now that genetic pre-disposition testing for scoliosis progression risk is available; An Early Stage Intervention Program has also been developed to provide scoliosis patients a non-bracing, non-surgical treatment option that allows them to take immediate action in the prevention of the next stage of the standard treatment process (spinal bracing or scoliosis fusion surgery).

While it is not the intention of CLEAR Institute to condemn the efforts of sincere and caring medical professionals who have dedicated their lives to helping individuals with scoliosis. We would, however, like to add to the current list of options; to educate those who are personally involved with scoliosis about what the research says; and, to empower these individuals to make their own decision regarding their own spine, and their own life.

The three medically-sanctioned methods of scoliosis treatment - observation, bracing, and surgery - have been around for decades. A great deal of research has been done on the risks & benefits of each option. However, the general conclusion of this research suggests that a new paradigm is desperately needed as there are many conflicts and inadequacies present in the current model.

Observation Only or the “watch & wait” stage
Once an individual has been diagnosed with scoliosis, no treatment is initially prescribed, and no action is immediately taken, until the Cobb angle has progressed to 25 degrees (which is an arbitrary figure. There is no clinical significance to this number). At this point, bracing is typically prescribed. This period, which is termed "watch & wait," consists only of regular visits to an orthopedic surgeon, where full-spine x-rays are taken consistently to gauge the progress of the patient's condition.

Spinal brace treatment (Generally recommended for curvatures 25 degrees and larger)
If there ever was a time when a patient could benefit most greatly from chiropractic, therapeutic exercise, or non-surgical intervention, it would undoubtedly be during the mild stages of the disease - before the muscles & tissues of the body have been deformed by months or even years of compensating for the abnormal twisting & bending of the spine.
Bracing dates back to approximately 650 AD, when Paul of Aegina suggested bandaging scoliosis patients with wooden strips. The first metal brace was developed by Ambroise Pare in the 16th century. Today, there is a bewildering assortment of braces in use, ranging from the venerable and bulky Milwaukee brace, to the traditional TLSO (thoraco-lumbar-sacral orthosis) braces such as the Boston and the Wilmington brace. There are "part-time" braces, designed to be worn at night: the Providence brace, and the Charleston brace. There are also "dynamic corrective braces" which may use soft, elastic materials and claim to be able to do more than simply stabilize the progression of scoliosis. An example of a dynamic corrective brace would be the SpineCor brace, developed at the Sainte-Justine Hospital in 1992, or the Copes brace, developed by Arthur Copes to be used in conjunction with his STARS (Scoliosis Treatment Advanced Recovery System) rehabilitation protocol.
This dizzying variety is further complicated by the fact that not every doctor prescribes the braces to be used in the same manner, and not every patient may follow their doctor's recommendations to the same extent. As a result, research is often conflicting (to say the least) in regard to the true effectiveness of bracing in scoliosis treatment. Some studies have shown very little difference between patients who wore the brace for the prescribed time, and those who wore it barely, if at all. Others have demonstrated patients who have been successfully stabilized for years by wearing a bracing constantly; yet, there are also studies on patients who wore the brace for 23 hours out of every day, seven days a week, and continued to worsen. In every case, all corrective benefit is lost very quickly once the patient stops wearing the brace, and the general consensus is that bracing may prove helpful for some, but not for others.

Spinal fusion surgery (Generally recommended of curvatures 40 degrees and larger)
Those patients for whom bracing fails to prevent the progression of their scoliosis are left with only one option: surgery. Those who are confronted with this choice may be told that having a metal rod fused to their spine will not impair their daily activities, and will reduce the rib arch & improve their cosmetic appearance. However, research has consistently shown that surgery - which primarily focuses upon the sideways bending, and does little to address the rotation of the spine (and hence the rib protrusion) - will actually cause the rib arch to worsen (Chen 2002, Goldberg 2003, Hill 2002, Pratt 2001, Weatherly 1980, Wood 1991, Wood 1997).

Spinal surgery, like most highly-invasive procedures, carries with it the ever-present risk of death. Although mortality rates of less than one percent are claimed, no surgeon can completely eliminate this possibility. There is also the danger of neurological damage, resulting in the loss of sensation or motor function to the arms & legs (paraplegia or quadraplegia). This has become a greater concern in recent years, as surgeons strive for greater corrections in their patients, and place more stress upon the nerves running through the spinal column.

The rate of hardware failure is virtually 100% over the course of a normal lifetime. It may occur immediately after the surgery or several years later, but one or more components of the hardware placed inside the body is highly likely to fail or break. The author of one study stated, "One would expect that if the patient lives long enough, rod breakage will be a virtual certainty". Another study found that amongst seventy-four patients who underwent the surgery, pseudoarthrosis (failed fusion) occurred in 27% of patients within a few years after the procedure.

The truth of the matter is that scoliosis is an abnormality of the spine which involves much more than merely a sideways curve. Yet the "effectiveness" of surgery is measured only by the degree to which it can reduce the lateral deviation through the application of brute force, and a fused spine is every bit as abnormal and dysfunctional as a scoliotic spine.

We can alter the natural course of this disease by identifying which patients are at the highest risk for severe progression via genetic testing (Scoliscore) and by implementing an aggressive, non-invasive Early Stage Scoliosis Intervention program that re-trains the brains involuntary postural controls centers before the spinal curvature reaches the 30 degree "buckling" point.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.

The evidence and studies are proving time and time again that back bracing for scoliosis has no effect on the curvature or natural progression of the condition.  This study even compared the results of bracing vs. the genetic testing predicted outcomes.  The results clearly show that bracing for scoliosis provides no benefit to the patient. 

J Ogilvie , L Nelson, R Chettier and K Ward

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA

author email corresponding author email

from 6th International Conference on Conservative Management of Spinal Deformities
Lyon, France. 21-23 May 2009

Scoliosis 2009, 4(Suppl 2):O59doi:10.1186/1748-7161-4-S2-O59

The electronic version of this abstract is the complete one and can be found online at: http://www.scoliosisjournal.com/content/4/S2/O59

Published: 14 December 2009

© 2009 Ogilvie et al; licensee BioMed Central Ltd.

Background

Orthotic treatment of children with AIS is a generally accepted treatment option. Failure of bracing to halt curve progression has been reported in 20% or more of patients, and it is known that some curves in children with AIS will not progress even if untreated. Success and failure rates of brace treatment vary considerably.

Purpose

We reviewed the response to brace treatment in patients who were also analyzed with a DNA-based adolescent idiopathic scoliosis progression test (AIS-PT) and compared this with the natural history of adolescent idiopathic scoliosis without treatment. Our purpose was to document the influence of orthotic care on the outcome at skeletal maturity.

Methods

Medical records and x-rays were reviewed, and DNA was collected with a saliva sample in two cohorts of Caucasian female AIS patients. A risk of progression score was calculated using 53 genetic markers with utility for calculating the risk of AIS curve progression from < 25° to > 40° before skeletal maturity or > 50° at maturity (1-200). Group A (2442 females) had no brace treatment and their outcome at maturity or surgery was known. Group B (308 females) were brace compliant for more than one year and their curve severity at maturity or surgery was known.

Results

There was little statistical difference in the curves representing risk of progression versus curve severity when the two groups were compared.

Conclusion

In this retrospective study of US Caucasian females, there was no statistically significant difference in the natural history of adolescent idiopathic scoliosis when comparing bracing treatment and no bracing treatment. At best, there was only a modest brace effect. Prospective trials with genotype homogeneity are needed to validate current assumptions about the efficacy of orthotic types and treatment regimens when bracing adolescent idiopathic scoliosis.