Scoliosis Awareness Day: Advanced Bracing at LOC
Scoliosis (pronounced sko-lee-o-sis) affects one in 250 children in the UK. Hippocrates was one of the original physicians to understand and write about the spine and coined the term skoliosis over 1500 years ago, “a bending” in Ancient Greek.
Sally Hews is The London Orthotic Consultancy’s lead scoliosis orthotist and earlier this year became certified in Schroth Best Practice™ to prescribe what is evidenced as the most effective brace for correcting scoliosis; the Gensingen Brace™ according to Dr Weiss. We interviewed Sally to discuss modern scoliosis treatment and what it involves.
What is scoliosis?
Scoliosis is a condition characterised by a twisted, curved spine, often in an S or C-shaped position. While it can be a complication of other conditions like muscular dystrophy, Cerebral Palsy, Marfan Syndrome and Ehlers-Danlos syndrome, often the causes are unknown.
Scoliosis can progress very aggressively during teenage growth spurts and when the cause is unknown and it becomes apparent during this time, it’s referred to as Adolescent Idiopathic Scoliosis (AIS). It can also occur between the ages of five and ten, when it’s known as Juvenile Idiopathic Scoliosis but it is not as common. For adults with scoliosis, once you are skeletally mature you cannot correct the curvature of the spine, but bracing can be used to reduce any associated pain.
What treatment options are there?
Some people with scoliosis do not require treatment. In other cases, it will be largely dependent on the severity and a person’s age. Older children and adolescents may require treatment to prevent the curve worsening during growth spurts. Some cases may require surgery to lessen their scoliosis, the procedure uses a bone graft to fuse the spine into a straighter position.
The Gensingen Brace™ according to Dr Weiss represents a non-surgical treatment option that actually corrects the patient’s curved spine.
What is the Schroth Best Practice method?
It’s an exercise and postural therapy method developed in the 1920’s in Germany by a physiotherapist to reduce pain and prevent spinal curve progression.
Original German Schroth therapy, taught in the Bad Sobernheim, is more directed at larger, stiffer adult curves and is effective at reducing pain and improving aesthetics – the look of the spine. More modern Best Practice Schroth is more appropriate for the younger adolescent scoliosis, providing the most effective loading through postural overcorrection and specific, efficient exercises for younger patient exercise regimes. Schroth is the most well-established, evidenced-based European treatment and is used throughout the world. In many countries the incidence of surgery for scoliosis is much lower than in the UK and USA and the use of conservative management is more prevalent.
LOC works with Schroth-certified physiotherapist Deborah Turnbull BSc. CSP and HCPC registered – with over 10 years experience of treating scoliosis privately and with more than 9 years NHS experience. Deborah is the only therapist in the UK trained in original Schroth and Best practice Schroth methods and is available in our clinics to provide intensive and one to one exercise packages and sessions to complement bracing treatment and is registered with AXA PPI insurers.
What does the Gensingen Brace™ bracing treatment involve?
The bespoke Gensingen™ brace is initially created using computer aided design/ computer aided manufacture (CAD/CAM).
It’s the first evidence-based orthotic treatment for scoliosis. Designed as a comfortable alternative to other traditional braces, the Gensingen™ approach gently realigns the spine and guides it into a corrective position. Success rates are currently over 95%, with the design centred around the theory that scoliosis should be tackled in 3 dimensions for a successful outcome.
Each customised Gensingen brace is made according to the following protocol: the assessment, along with other medical notes taken by our orthotists, is sent to Dr Hans-Rudolf Weiss (grandson of Katharina Schroth) who applies his brace design and correction for the individual patient. This template is then used by LOC to make the brace in-house which is fitted by our orthotists to ensure an optimum fit.
How does the Gensingen™ brace differ from other braces?
The Boston brace has been relatively commonplace since its development in the 1970s, it is currently prescribed on the NHS but strong evidence to support the use of the Boston brace is lacking. While the Boston can stop a spinal curve from worsening, it does not correct the existing spinal deformity.
The Gensingen™ is closely designed according to the Schroth method, and is the most compatible with this form of physiotherapy. Despite the Gensingen™ also being a ‘hard’ brace made from polyethylene, it’s more comfortable than previous braces available. Pockets of space built within the brace leave room for the curve to move into, and for the patient to breathe, whereas the Boston brace is a completely enclosed body jacket which compresses and can cause longer, stiffer curvatures. The Gensingen™ works by guiding the movement of the spine so that there is space for it to move into.
You can find out more via The Schroth Best Practice Program website and Dr Weiss’ bracing technology in his publication "Brace technology" Thematic Series - the Gensingen brace™ in the Treatment of Scoliosis.
The London Orthotic Consultancy now has two orthotists certified to prescribe, manufacture and fit The Gensingen™ brace. If you are seeking non-surgical treatment for scoliosis, give us a call or drop us an email to book a consultation with our scoliosis clinicians David or Sally today.