Scoliosis is the medical term that describes the abnormal twisting and curvature of the spine. It occurs most often during the growth spurt just before puberty. It affects around three to four children in every 1,000 in the UK and is most typically seen in children between the ages of 10 and 15. It is also more common among females than males.
Since LOC opened its Scoliosis clinic in 2017 we have treated a broad age range of patients from 3-year-olds to 80-year-olds. Even those with severe scoliosis where the Cobb angle is in excess of 40 degrees have responded well to the combination of bracing with the Gensingen brace and a physiotherapy programme that follows the principles of Schroth Best Practice.
Scoliosis can be treated surgically and non-surgically depending on factors such as age and the severity of the curve.
At LOC, we have pioneered non-surgical treatment through back bracing & specialist physiotherapy since spinal surgery is extremely invasive and can lead to complications.
The Gensingen Brace by Dr Weiss® is the first orthotic treatment for scoliosis that is evidence-based.
It is now recommended by scoliosis clinics around the world as the preferred alternative to surgery since it has been proven to reduce Cobb angles and improve posture.
Our bracing treatment can be combined with a comprehensive physiotherapy programme that adheres to the world-renowned Schroth Best Practice
Our treatment package price includes all reviews and on-site adjustments of the brace by our certified orthotists.
There may currently be cancellations or delays to your child’s spinal surgery for several reasons.
At LOC, we are here to assist where possible. We remain open in a COVID safe environment. Using our corrective bracing, we can halt progression of the curve, balance posture & reduce any back pain.
The 3 age-related groups for scoliosis are juvenile, adolescent and adult.
Our treatment recommendations will be based on the severity of the Cobb angle and the age of the patient. If the Cobb angle is over 25° it is likely that we will recommend the Gensingen brace & Schroth therapy.
A normal back has a 20° to 45° curvature in the upper part of the back, yet anything above 45° is called kyphosis.
Kyphosis causes pain if excessive or if in the wrong place such as the lower back. Our bespoke physiotherapy programme can improve muscle lengths & spinal extensor strength, reducing postural pain.
Scoliosis may first be noticed by a change in the appearance of a child’s back. Symptoms can include:
Each scoliosis curve is unique. The spine may curve to the left or right and it can happen in different parts of the spine. If it is in the chest area it is called ‘thoracic’ scoliosis, while if it is the lower part of the spine it is called ‘lumbar’ scoliosis. It is also possible to have two curves; this is called a double curvature and the spine may look like an ‘S’ shape from behind. It is further possible to have more compensatory curves at the top and bottom of the spine.
As scoliosis is a three-dimensional condition and the spine is always trying to compensate there are numerous potential curve variations. However, the most common curve is the right thoracic curve.
At the moment you may find it difficult to get a referral to your local hospital, we can provide clinical assessments and refer your child for any necessary back x-rays or scans required. These scans will help us determine the progression factor. This is the incidence of progression according to the formula by Lonstein and Carlson (see graph); this considers the severity of the curve and the skeletal maturity of the patient.
According to Dr Weiss monitoring and observation is indicated when the risk of progression is less than 40%. Specialist Schroth physiotherapy is indicated when the risk of progression is 40-60% and bracing is indicated when the risk is over 60%.
A patient’s treatment can involve one or all of these elements: observation, physiotherapy and bracing. The correct prescription and combination of these elements will be determined by one of our team of specialist scoliosis clinicians. At the patient’s initial consultation, the clinician will look at posture, the exact nature of the curve and its flexibility and also assess the pain associated with the condition. The skeletal maturity and age of the individual will also affect the recommended treatment plan, as described above.
Scoliosis can progress quickly when the skeleton is still growing or during hormonal changes so if you are concerned about your child contact us.
At the initial consultation, we will conduct a detailed clinical assessment to assess posture/leg length/progression factor of the curve/flexibility of the body and then discuss the most appropriate treatment. If you have already been diagnosed with scoliosis you will need to bring with you a recent X-ray of your spine. The existence of scoliosis is established by measuring the Cobb angle of the spinal curves. The Cobb angle was first described in 1948 by Dr John R Cobb, an American orthopaedic surgeon. A Cobb angle of 10° is regarded as the minimum angulation to define scoliosis.
We use a scoliometer to measure the angle of trunk rotation. This is a small non-invasive device that is placed over the spine while the patient being measured is in a forward bending position. As it provides a reading in degrees, it is important not to confuse the Cobb reading with a scoliometer reading. The scoliometer is a useful tool for monitoring our patients while reducing the need for x-rays.
Our treatment recommendations will be based on the severity of the Cobb angle and the age of the patient. This allows us to calculate the risk of progression and determine the most appropriate conservative management for each patient. We also factor in the individual’s lifestyle and symptoms.
The criteria for treatment is based on the patient’s Cobb angle:
Victor the Robot, our new Computer Numerical Control milling machine, in action! Victor is noisy, but he’s transforming our ability to design and manufacture orthotic devices at our Kingston-upon-Thames clinic.
Manufactured by Rodin4D, Victor is capable of milling complex ergonomic shapes, meaning that we can now potentially assess a spinal orthotic patient, manufacture the orthosis and have it fitted, all in the space of a day. Victor can do everything we need to do for our patients, in-house and in the shortest time possible with no compromise on quality.
In year three of school, Daisy’s mum, Sara, noticed something amiss with her posture. “I’m an orthopaedic physiotherapist, so I recognised that something was not quite right and suspected that we might be looking at scoliosis,” she explains ... continue reading ...
LOC recently heard from one of our young patients, Beau, who was diagnosed in 2020 with juvenile idiopathic scoliosis. Beau has embraced her treatment programme wholeheartedly. Her positive outlook and ‘can-do’ attitude are inspiring ... continue reading ...
Ariana was examined by LOC physiotherapist and scoliosis expert Deborah Turnbull, who checked her spinal rotation using a scoliometer device that measures how much a rib hump protrudes - known as ‘angle of trunk rotation’ (ATR) ... continue reading ...
It is fair to say that Venetia had been through the mill before she came to see us in March. It started about 3 years ago when Venetia kept getting bad cramps at night. Having rejected the quinine prescription suggested by her GP ... continue reading ...
LOC first met 11-year-old Yasmin after she found out she had adolescent idiopathic scoliosis quite by chance; an X-ray taken for a chest complaint revealed she had abnormal twisting and curvature of the spine ... continue reading ...
We talk to the father of one of our scoliosis patients Ricarda, a thirteen-year-old horse rider and regional kickboxer, about her experience with adolescent idiopathic scoliosis and treatment with the Gensingen Brace by Dr Weiss® ... continue reading ...
Motivated Angelina is a thirteen-year-old scoliosis patient currently going through Gensingen Brace by Dr Weiss® treatment, here her mother Paola talks to us about her scoliosis journey and her experience with the brace ... continue reading ...
My results are amazing and unexpected, and I am glad that I received the brace through LOC. I am still wearing the brace 18 months later and my back feels even straighter. Thanks to LOC I realised that I wanted to help people with similar if not the same condition as me, so I am now going to Salford University in September to study Orthotics and Prosthetics so I will hopefully be able to help others with Scoliosis as much as LOC has helped me.
If you say something is going to be easy it will be easy and if you say something will be hard it will be hard. So, I'm just going to say that wearing my brace is easy. And as it turns out, it really is.
Sally and Debs have helped remove the stress from our situation. They have given us hope based on their extensive knowledge and expertise.
I had my brace fitted and I was also given a personalised exercise programme to help with my 3D rotation. Not only was I wearing this new brace but I still had my pectus brace on and the amazing orthotists managed to combine the two so they worked together. I really struggled with this at first; however, I kept going and now I’m really glad I did. My scoliosis overcorrected by 10 degrees and I was able to reduce my scoliosis brace wear to 16 hours a day within 6 weeks.
Don’t wait. It’s about the children because they are more likely to be confident in their late teens if you act quickly and support them. We have been lucky because we understand the condition well. That’s one of the main things, to be honest. It was hard work, but it pays off in the end.
I'd highly recommend LOC to anybody. They’re just so interested, which you don't get at many places because adult scoliosis is actually a huge area but there are very few people interested in it.
The brace is very light. Obviously, the first couple of days we were told it was going to be uncomfortable for her, I bought so many pillows! But although the first night was not very comfortable, the second night she got used to it and then she was wearing it all day long and I thought ‘that’s brilliant!’ She was only taking it off for two or three hours to go out with friends or do the exercises, but she didn’t have any problems really.
Debs and Sally are fantastic. I mean, they’ve become like family now. They are extraordinary people and do such good work with these kids, both of them, it’s fantastic. The whole experience has been very good. They make you feel welcome from the beginning, and you can ask as many questions as you want, and they answer everything. If you have a problem they give you their personal mobile so you can just call them if you have a problem and they’ll solve it straight away. I’m very pleased with the treatment, the people, with everything.
She’s wearing the brace all the time now and she’s doing very well. She’s very good at school too, the brace doesn’t get in the way of anything. It fits underneath her school uniform and you can’t see it. Sometimes I even have to ask her when she’s sitting down if she’s wearing it because I can’t see it! She says ‘of course mummy’ and I say ‘let me try!’ I have to knock through the clothes and only then can I hear she’s wearing the brace!
Obviously, the results speak for themselves. I would definitely credit LOC, but if I were to give any advice [to parents in a similar position] it would be to contact Debs and Sally. Ricarda likes it there, she loves the people like Debs and Sally and felt really comfortable, everything was really relaxed and nice. She worked really hard during training with Debs who kept saying that Ricarda was such a workhorse!
He’s been very positive since the first day and this determination has certainly paid off. In just two months, Rares’s Cobb angle has reduced from 52֯ to 24֯ in a brace and his ribcage has de-rotated from 18֯ to 12֯, so the rib hump has significantly improved.
I finally found that I had arrived at the right place and something was actually being done.
My pain levels are hugely improved, my ribs were tender and now they are not. My brace was made individually for me. It’s not one size fits all and, if it is not completely perfect, LOC alters it on the spot. I was so surprised that I could wear the brace under my clothes, I did not need to go and buy anything, I just wear loose tops.
22-month-old Scarlett, who has periventricular leukomalacia, struggled to stand independently because of the condition, but her new AFOs from our Bolton clinic are making a world of difference!
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