© 2011 the spinecorporation limited pediatric treatment goal spinecor custom scoliosis brace the...

© 2011 The SpineCorporation Limited

Pediatric Treatment Goal SpineCor Custom Scoliosis Brace

The SpineCor® Dynamic Corrective Brace

• Research in 1992 at Ste-Justine Hospital, Montreal, Canada.

• Professor Charles H Rivard MD; Christine Coillard MD.

• Canadian Government Research Project.

• 12 million dollars.

• 65 researchers

• Orthobiom

• Blood Test

• SpineCor


The SpineCor® Dynamic Corrective BracePaediatric SpineCor Brace

Growth Modulation

Localised 3D Vertebral Deformity

Destabilisation of the Spine

Postural Disorganisation

Neuro-musculo-skeletal Dysfunction

Asymmetric Biomechanical Growth

Plate Loading IdiopathicScoliosis

Genetic FaultTemporary asymmetric delay in ossification (growth) of the posterolateral segment of vertebra


The SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis

Genetic temporary fault

Delayed ossification in the postero-lateral part of the

vertebra

Initial deformity


The SpineCor® Dynamic Corrective BraceOrigin of the Localised 3D Deformity

NEURO-CENTRAL CARTILAGES

Growth plates involved in the 3D development of part of the vertebral body, transverse and articular processes and laminae.


The SpineCor® Dynamic Corrective BraceLocalised 3D Vertebral Deformity

Growth Modulation




Neuro-musculo-skeletal Dysfunction

Asymmetric Biomechanical Growth

Plate Loading



IdiopathicScoliosis


1. Lateral Wedging

2. Anterior/Posterior Wedging

3. Rotational Deformity



Rib Deformity

• Decreased distance between the ribs in concave side

• Highlights the lateral wedging of the vertebrae


The SpineCor® Dynamic Corrective BraceEvidence of Lateral Wedging

Modification of the sagittal profile

• Hypokyphosis• Hypolordosis • Flat back


The SpineCor® Dynamic Corrective BraceEvidence of Anterior/Posterior Wedging

Arc from spinous process through the vertebral body

• Rotation in the rest of the spine is a disorientation as a result of this


The SpineCor® Dynamic Corrective BraceEvidence of Rotational Deformity

INITIAL LOCALISED 3D VERTEBRAL DEFORMITY PATTERN

• Specifically confined to one vertebra +

half of the vertebra above + half of the vertebra below

• At or around the apex of the major structural curve



• The other vertebras are disoriented but not deformed!



Growth Modulation




Neuro-musculo-skeletal

Dysfunction

Asymmetric Biomechanical

Growth Plate Loading IdiopathicScoliosis




• Consequence of the initial 3D vertebral deformity.

• May result in 1 or more curves:

• Primary structural curve contains the deformed vertebrae and has greatest potential to progress

• Secondary compensatory curve has limited potential to progress


The SpineCor® Dynamic Corrective BraceDestablisation of the Spine

Growth Modulation





Dysfunction


Growth Plate Loading IdiopathicScoliosis




• Postural disorganization is closely related to the type of curve.

• It permits to get an indirect 3D evaluation of the scoliosis curve.

• The postural disorganization contributes to the aggravation of the curve.


The SpineCor® Dynamic Corrective BracePostural Disorganisation

Growth Modulation





Dysfunction


Growth Plate Loading

IdiopathicScoliosis




DREIDIMENSIONALE SKOLIOSE BEHANDLUNG

CHRISTA LEHNERT-SCHROTH

Postural disorganization affects the orientation of the whole skeleton:

• Shoulder girdle

• Rib cage

• Pelvic girdle

• Lower limbs

• Gait is also affected!


The SpineCor® Dynamic Corrective BraceNeuro-Musculo-Skeletal Dysfunction

Muscular dysfunction

• Length, strength and direction altered

• Shorter – concave side

• Longer – convex side

DREIDIMENSIONALE SKOLIOSE BEHANDLUNG

CHRISTA LEHNERT-SCHROTH 1998

Muscles can not actively work to correct the progressing deformity



SPINAL SYSTEM

MOTOR CONTROL

CENTER

PERIPHERAL RECEPTORS

Ligament / muscle / joint capsule

FEED BACK

GROWTH MATURATION

Abnormal Movement

NEUROLOGICAL DYSFUNCTION



Growth Modulation





Dysfunction


Growth Plate Loading

IdiopathicScoliosis


Stokes IA



Once the scoliosis is established, the asymmetrical loading of the growth plates, due to the biomechanical forces action, results in an asymmetrical vertebral growth which increases the vertebral wedging increasing the spinal curvature.

Stokes IA


The SpineCor® Dynamic Corrective BraceAsymmetrical Loading of the Spine

• Compressive forces tend to inhibit skeletal growth.

• Distractive forces tend to accelerate skeletal growth.

• Scoliosis deformity holds pressure on the vertebrae which does not allow the bones of the spine to grow properly, basically stunting growth.

• Repetitive dynamic loads placed on bone trigger remodelling; static loads do not.

• The fundamental research proved that the bone growth is stimulated by the alternation of compression and decompression.


The SpineCor® Dynamic Corrective BraceHueter-Volkmann Principle

• Research has proven that bone growth is stimulated by the alternation of compression and decompression.

• Static distraction does not stimulate the bone growth.

- Modulation of vertebral and tibial growth by compression loading: diurnal versus full-time loading. Stokes IA et al, 2005

- Biomechanical spinal growth modulation and progressive adolescent scoliosis - a test of the 'vicious cycle' pathogenetic hypothesis: Summary of an electronic focus group debate of the IBSE. Stokes et al, 2006

- Static versus dynamic loading in the mechanical modulation of vertebral growth. Akyuz E et al, 2006

- Biological response of the intervertebral disc to dynamic loading. Walsh AJ et al, 2004

- The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment. Hawes MC et al, 2006


The SpineCor® Dynamic Corrective BraceBone Growth Stimulation

• Curve opening needs to be focussed at the level of the initiating deformity.

• Vertebral growth plate dynamic loading is essential to get a true correction.

• Static opening merely stops progression and does not facilitate true correction.


The SpineCor® Dynamic Corrective BraceCatch up of the Vertebral Side Deficient in Growth

© 2011 the spinecorporation limited pediatric treatment goal spinecor custom scoliosis brace the...

Documents

d deformity slide

d vertebral deformity

d vertebral deformity

rib deformity

vertebra initial deformity

growth modulation

ossification growth

d development