Treating Scoliosis

Our CCS Paneled practitioners have many years of combined experience treating scoliosis.

We value the importance of addressing the concerns of the family as we care for our young patients, so they are fully informed about the care their child receives. Contact one of our pediatric orthotic practitioners to speak with a scoliosis specialist who can answer your questions.

Pediatric practitioners at all our locations have experience treating scoliosis. They are familiar with the different types of scoliosis, the most common being Adolescent Idiopathic Scoliosis, which develops when a patient has rapid growth spurts. Our practitioners have a long history of working with Shriner’s hospital patients and decades of combined experience treating scoliosis. Practitioner Brian Lee holds scoliosis clinics at four different California Children’s Services locations in the Bay Area and along the Peninsula. You can read about our scoliosis team and protocol here.

Collier and Laurence Orthotists are now Certified to provide the 3D-Cad Cam Chéneau-Gensingen Scoliosis Brace. The 3D Cad Cam Cheneau-Gensingen Scoliosis Brace is the gold standard of scoliosis bracing. The Chéneau-Gensingen brace utilizes the latest bracing technology for the best possible outcome. Learn more here about our 3D scoliosis training.

Our CCS Paneled practitioners can also treat scoliosis with more traditional methods if the Schroth Method is not appropriate. The traditional brace for adolescent idiopathic scoliosis is the Boston TLSO (thoracic-lumbar-sacral orthosis) worn full-time (18-23 hours/day). Studies have shown that bracing can successfully prevent curve progression in the overwhelming majority of patients. The Boston TLSO fits under the arms and around the rib cage, lower back, and hips. Click the button to watch a video that demonstrates the principle’s of the Boston Brace.

Scoliosis Brace Protocol

When seeking scoliosis treatment, protocol is determined by the referring physician. This procedure can be different for different doctors, and the Collier and Laurence team members work closely with your providers to provide the best possible outcome for our patients.

The Collier-Laurence Methodology

Once our patient receives their brace, we ask them to get an x-ray, in their brace, in 6-8 weeks from the day of delivery. We need to see a copy of the x-ray so we can assess the function of the brace. Scoliosis treatment requires on-going adjustments and continued care as the patient grows. Brace straps wear out in 3-5 months and need to be replaced and then re-marked for tightness.

When patient has 4 month follow-up with an x-ray in brace, there is good information about whether the brace is working or not.  The “medicine” of the brace is to push on the curve and try to reduce it by 50%.  When the follow up is with an x-ray that is out of brace, it is more difficult to assess what needs to be done to the brace for better performance.

There are different ways to measure for these braces and to blueprint their design. All require an initial x-ray for the blueprint to be made. We have found that fitting modules is far superior to having braces made and finished by manufacturers. Follow-up on brace wear will be done either in a clinic situation or in the office. We are looking for a number of things which include:  Cobb angle, height and weight, posterior opening of brace, length of brace, tightness, and any pain issues. We find subsequent x-rays in brace to be the most useful if the brace needs to be improved. Brace adjustments without x-rays in brace are more challenging.

For scoliosis follow up, not all locations and providers work in the same way.

The methods for follow up are not the same at all hospitals. Ideally, the patient should get an x-ray 4-6 months after their appointment. The x-ray should be done wearing their full-time brace. Follow up with your practitioner accomplishes a number of things:

  • Improved communication between patient, parent, doctor and orthotist
  • Improved compliance by having concerned professionals explaining the importance of wearing the brace
  • X-ray verification that the brace is working properly or indications that the brace needs adjustment to be more effective

Some providers take an initial x-ray in the brace, but their subsequent x-rays are done out of the brace.  This does not always give our practitioners the information they need to know. Patient follow up periods can be 4, 6, or 12 months depending on physician.

Tip: Speak with your provider about what to expect during treatment. Write down your questions between appointments so you can easily remember everything you want to discuss.

Community Resources: There are support groups online and offline that can be a huge benefit for young patients learning to deal with their diagnosis and wearing a brace. To get you started, here is a Facebook link for Curvy Girls Scoliosis Foundation. They also have a website with additional information.

 Please share this video if you have a child or adolescent with scoliosis.