We are now offering a same-day scoliosis service

LOC Scoliosis Brace

Introducing the LOC Scoliosis Brace

The London Orthotic Consultancy has been providing bracing treatment for scoliosis since it opened in 2005. For the last five years, LOC has prescribed and fitted derivatives of the Cheneau-Gensingen brace for its scoliosis patients where active intervention was indicated. Dr Jaques Cheneau developed his first brace in 1979. His brace design acknowledged that scoliosis is a three-dimensional condition and focuses on the three-dimensional correction of the spine in the coronal (front), transverse (rotational) and sagittal (side) planes. Goals for brace wearers are stabilization at a minimum but LOC has witnessed first-hand significant spinal corrections in our patients, particularly juveniles and adolescents.

Since its initial development, Cheneau bracing has been intertwined with the Schroth concept for scoliosis. Dr Cheneau visited Katherina Schroth and Christa Lehnert-Schroth at their renowned clinic in Germany. He immediately understood the efficacy of the Schroth breathing concept and incorporated this into his brace designs using the augmented Lehnert-Schroth curve-pattern classifications which for decades have been the basis of Schroth scoliosis treatment.

 

Today there are several Cheneau-Gensingen derivatives. LOC has been involved with the Cheneau-Gensingen brace over the last 5 years, but more excitingly, we are now able to announce the launch of the UK’s first complete, in clinic, asymmetric brace – the LOC Scoliosis Brace. Based on recurring patient and UK based consultant feedback over the past 5 years, the LOC Scoliosis Brace has been fine-tuned to ensure we are achieving as much skeletal correction as possible in-brace for each individual user, whilst also ensuring that our brace is as comfortable as possible.

The above is only possible because of the strengths of our current team. Indeed the clinical lead of this team oversaw the production, fitting and management of 64% of LOC’s Cheneau-Gensingen braces during the preceding five years. This currently makes her the most experienced Cheneau-Gensingen bracer in the UK. This knowledge, alongside the valuable feedback and thoughts from other clinicians, patients, parents and consultants has allowed us to further develop our approach to bracing. As a clinic, we understand the absolute time-critical nature of treating scoliosis. We understand there can be lengthy delays whilst accessing other services, which can ultimately lead to the progression of scoliosis. That is why we have invested in our manufacturing team so that we are now able to offer an extremely rapid turnaround on scoliosis braces. The custom-made LOC Scoliosis Brace is now available for fitting within hours of the assessment appointment, due to the dedication and process-driven LOC manufacturing team.

 

 

LOC Scoliosis Brace

How does the LOC Scoliosis Brace work?

The general protocol in the UK on the NHS is, if the Cobb angle is less than 20°, the client is to be monitored. If the cobb angle measures between 20° and 40°, then typically a patient will be referred to an orthotic service for a Boston or a TLSO brace to delay the progression of the curve. According to NHS guidelines, if a curve exceeds 40° then the patient would be advised to have surgery. To slow the progression of the curve during growth spurts, the Boston and the TLSO brace are prescribed on the NHS.

In contrast, LOC uses a published risk of progression formulae – which considers the patient’s chronological age, skeletal age (Risser sign) and the size of the presenting curve. If it is agreed a LOC Scoliosis Brace is required, we can actively reduce the curvature by loading the spinal bones 3 dimensionally to change their shape (thereby reducing the Cobb angle) whilst growth is completed. The LOC Scoliosis Brace also helps with pain management, reduces the need for surgery later in life and improves the cosmetic appearance

The LOC Scoliosis Brace is a much more tailored brace with bespoke 3-point pressure systems. This means that we can keep plastic down to an absolute minimum, making them smaller and more comfortable than traditional NHS Braces. The image below shows a traditional Boston brace which was made for a client on the left and a LOC Scoliosis Brace (for the same client) on the right.

OVER-CORRECTIVE TREATMENT

How corrective is the LOC Scoliosis Brace?

The general protocol in the UK is that if an x-ray is taken in brace, a ‘good’ brace should aim to reduce the original curve by 50%.

At LOC, we often refer patients for a rapid low dose scan to confirm the efficiency of our braces following the fitting. This scan is typically performed at the 2-month mark in other braces, and changes are then made to improve the fit of the brace and the correction in the brace. We have found that a rapid scan gives the clinician a very clear indication as to the correction that will be achieved, whilst ensuring no time is wasted (and therefore correction lost) while waiting for this scan.

Whilst it varies from patient to patient, the LOC Scoliosis Brace offers more than 50% skeletal correction. To the extreme, we have seen corrections exceeding 100% (as below) in the LOC Scoliosis Brace, which is why these braces can be termed ‘over-corrective’. In these instances, it is possible to proceed with reduced brace wearing hours, or if full time bracing is still indicated, the brace can be altered. This ‘over-correction’ gives the wearer the greatest chance at skeletal correction. If for any reason, our clinician is not fully satisfied with the skeletal in-brace correction after receiving the x-ray, the brace will be re-modelled and re-made (free of charge) as part of a multi-colleague meeting – this ensures all our patients are in gold standard braces, whilst not losing any possible corrective time in-brace. 

Examples of correction that can be achieved in the LOC Scoliosis Brace are as follows:

Example 1: Over correction of a curve in a LOC Scoliosis Brace. This patient was then able to reduce the hours of brace wear.

Example 1: Over correction of a curve in a LOC Scoliosis Brace. This patient was then able to reduce the hours of brace wear.

Example 2: 80% in-brace skeletal correction in a LOC Scoliosis Brace.

Example 2: 80% in-brace skeletal correction in a LOC Scoliosis Brace.

Example 3: Excellent in-brace correction in a LOC Scoliosis Brace.

Example 3: Excellent in-brace correction in a LOC Scoliosis Brace.

Will the LOC Scoliosis Brace improve my/my child’s posture?

Due to the 3-dimensional focus built within the LOC Scoliosis Brace, we expect to see postural improvements within 2 months, which continue to improve with good brace compliance. This can also be true in adult scoliosis patients. This can be in the ‘rib hump’ measure (rotation from the scoliosis), but also in waistline symmetry, shift of the hips and general postural re-balance. If we are able to ensure the weight line coming down from the head is more centralized over the pelvis following treatment, the patient’s overall prognosis is much improved.

Example 1: Waistline and pelvic correction in an adolescent after only 4 weeks of wearing a LOC Scoliosis Brace. This will continue to improve throughout treatment.

Example 1: Waistline and pelvic correction in an adolescent after only 4 weeks of wearing a LOC Scoliosis Brace. This will continue to improve throughout treatment.

What is the appointment schedule?

Assessment appointment – a recent out of brace x-ray is essential at this stage (so please bring one into the clinic or discuss this with the clinician beforehand). A series of scans, photographs and measurements are taken by one of our scoliosis clinicians. Based on this input, the bespoke LOC Scoliosis Brace is then modelled using CAD/CAM technology and our in-house manufacturing unit then produces the brace.

Fitting appointment – the brace is then fitted by one of LOC’s scoliosis clinicians. This is typically 10 working days following the assessment, however, with careful planning, this can be brought forward (and even fitted on the same day as the assessment!) when indicated/required. Please speak to your clinician if you feel this would be of benefit to you or your child.

Reviews – we typically like to review a scoliosis brace 2 weeks after the fitting appointment. This allows us to make tiny adjustments and to ensure the user is settling in well and managing fine at home.

We then plan for the in-brace x-ray and review the correction and adjust the brace as necessary.

Once this has taken place, we monitor each patient's progress with regular review appointments - typically every 2-3 months. We welcome communication from parents and patients throughout the treatment with our clinical team. We are then able to quickly respond to make brace adjustments as a patient grows.

 

Get in Touch

Should you have any further questions, we would be delighted to offer a virtual free of charge phone call or assessment. Please drop an e-mail to [email protected] or complete a contact form.

 

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GALLERY

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