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© 2011 The SpineCorporation LimitedPediatric Treatment GoalSpineCor Custom Scoliosis BraceThe SpineCor® Dynamic Corrective...
• Research in 1992 at Ste-Justine Hospital, Montreal, Canada.• Professor Charles H Rivard MD; Christine Coillard MD.• Cana...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
Genetic temporary faultDelayed ossification in thepostero-lateral part of thevertebraInitial deformity© 2011 The SpineCorp...
NEURO-CENTRAL CARTILAGESGrowth plates involved in the 3Ddevelopment of part of the vertebralbody, transverse and articular...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
1. Lateral Wedging2. Anterior/Posterior Wedging3. Rotational Deformity© 2011 The SpineCorporation LimitedThe SpineCor® Dyn...
Rib Deformity• Decreased distance between the ribs in concave side• Highlights the lateral wedging of the vertebrae© 2011 ...
Modification of the sagittalprofile• Hypokyphosis• Hypolordosis• Flat back© 2011 The SpineCorporation LimitedThe SpineCor®...
Arc from spinous process throughthe vertebral body• Rotation in the rest of the spineis a disorientation as a result ofthi...
INITIAL LOCALISED 3D VERTEBRALDEFORMITY PATTERN• Specifically confined to one vertebra +half of the vertebra above + half ...
• The other vertebras are disorientedbut not deformed!© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective ...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
• Consequence of the initial 3D vertebraldeformity.• May result in 1 or more curves:• Primary structural curve contains th...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
• Postural disorganization is closely related tothe type of curve.• It permits to get an indirect 3D evaluation ofthe scol...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
DREIDIMENSIONALE SKOLIOSEBEHANDLUNGCHRISTA LEHNERT-SCHROTHPostural disorganization affects theorientation of the whole ske...
Muscular dysfunction• Length, strength and direction altered• Shorter – concave side• Longer – convex sideDREIDIMENSIONALE...
SPINAL SYSTEMMOTORCONTROLCENTERPERIPHERAL RECEPTORSLigament / muscle / jointcapsuleFEED BACKGROWTHMATURATIONAbnormalMoveme...
Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal ...
Once the scoliosis isestablished, the asymmetricalloading of the growth plates,due to the biomechanicalforces action, resu...
• Compressive forces tend toinhibit skeletal growth.• Distractive forces tend toaccelerate skeletal growth.• Scoliosis def...
• Research has proven that bone growth is stimulated by the alternation of compressionand decompression.• Static distracti...
• Curve opening needs to be focussed at thelevel of the initiating deformity.• Vertebral growth plate dynamic loading ises...
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Treatment goal spine cor brace 5 01-2013

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Treatment goal spine cor brace 5 01-2013

  1. 1. © 2011 The SpineCorporation LimitedPediatric Treatment GoalSpineCor Custom Scoliosis BraceThe SpineCor® Dynamic Corrective Brace
  2. 2. • 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© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BracePaediatric SpineCor Brace
  3. 3. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate Loading IdiopathicScoliosisGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebra© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  4. 4. Genetic temporary faultDelayed ossification in thepostero-lateral part of thevertebraInitial deformity© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceOrigin of the Localised 3D Deformity
  5. 5. NEURO-CENTRAL CARTILAGESGrowth plates involved in the 3Ddevelopment of part of the vertebralbody, transverse and articular processes andlaminae.© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceLocalised 3D Vertebral Deformity
  6. 6. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate LoadingGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebra© 2011 The SpineCorporation LimitedIdiopathicScoliosisThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  7. 7. 1. Lateral Wedging2. Anterior/Posterior Wedging3. Rotational Deformity© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceLocalised 3D Vertebral Deformity
  8. 8. Rib Deformity• Decreased distance between the ribs in concave side• Highlights the lateral wedging of the vertebrae© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceEvidence of Lateral Wedging
  9. 9. Modification of the sagittalprofile• Hypokyphosis• Hypolordosis• Flat back© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceEvidence of Anterior/Posterior Wedging
  10. 10. Arc from spinous process throughthe vertebral body• Rotation in the rest of the spineis a disorientation as a result ofthis© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceEvidence of Rotational Deformity
  11. 11. INITIAL LOCALISED 3D VERTEBRALDEFORMITY PATTERN• Specifically confined to one vertebra +half of the vertebra above + half ofthe vertebra below• At or around the apex of the majorstructural curve© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceLocalised 3D Vertebral Deformity
  12. 12. • The other vertebras are disorientedbut not deformed!© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceLocalised 3D Vertebral Deformity
  13. 13. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate Loading IdiopathicScoliosisGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebra© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  14. 14. • Consequence of the initial 3D vertebraldeformity.• May result in 1 or more curves:• Primary structural curve contains thedeformed vertebrae and has greatestpotential to progress• Secondary compensatory curve haslimited potential to progress© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceDestablisation of the Spine
  15. 15. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate Loading IdiopathicScoliosisGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebra© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  16. 16. • Postural disorganization is closely related tothe type of curve.• It permits to get an indirect 3D evaluation ofthe scoliosis curve.• The postural disorganization contributes to theaggravation of the curve.© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BracePostural Disorganisation
  17. 17. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate LoadingIdiopathicScoliosisGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebra© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  18. 18. DREIDIMENSIONALE SKOLIOSEBEHANDLUNGCHRISTA LEHNERT-SCHROTHPostural disorganization affects theorientation of the whole skeleton:• Shoulder girdle• Rib cage• Pelvic girdle• Lower limbs• Gait is also affected!© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceNeuro-Musculo-Skeletal Dysfunction
  19. 19. Muscular dysfunction• Length, strength and direction altered• Shorter – concave side• Longer – convex sideDREIDIMENSIONALE SKOLIOSE BEHANDLUNGCHRISTA LEHNERT-SCHROTH 1998Muscles can not activelywork to correct theprogressing deformity© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceNeuro-Musculo-Skeletal Dysfunction
  20. 20. SPINAL SYSTEMMOTORCONTROLCENTERPERIPHERAL RECEPTORSLigament / muscle / jointcapsuleFEED BACKGROWTHMATURATIONAbnormalMovementNEUROLOGICAL DYSFUNCTION© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceNeuro-Musculo-Skeletal Dysfunction
  21. 21. Growth ModulationLocalised 3D VertebralDeformityDestabilisation of theSpinePostural DisorganisationNeuro-musculo-skeletal DysfunctionAsymmetricBiomechanical GrowthPlate LoadingIdiopathicScoliosisGenetic FaultTemporary asymmetric delay inossification (growth) of theposterolateral segment of vertebraStokes IA© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCircle of Idiopathic Scoliosis
  22. 22. Once the scoliosis isestablished, the asymmetricalloading of the growth plates,due to the biomechanicalforces action, results in anasymmetrical vertebralgrowth which increases thevertebral wedging increasingthe spinal curvature.Stokes IA© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceAsymmetrical Loading of the Spine
  23. 23. • Compressive forces tend toinhibit skeletal growth.• Distractive forces tend toaccelerate skeletal growth.• Scoliosis deformity holdspressure on the vertebraewhich does not allow thebones of the spine to growproperly, basically stuntinggrowth.• Repetitive dynamic loads placed on bone trigger remodelling; static loads do not.• The fundamental research proved that the bone growth is stimulated by thealternation of compression and decompression.© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceHueter-Volkmann Principle
  24. 24. • Research has proven that bone growth is stimulated by the alternation of compressionand 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© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceBone Growth Stimulation
  25. 25. • Curve opening needs to be focussed at thelevel of the initiating deformity.• Vertebral growth plate dynamic loading isessential to get a true correction.• Static opening merely stops progression anddoes not facilitate true correction.© 2011 The SpineCorporation LimitedThe SpineCor® Dynamic Corrective BraceCatch up of the Vertebral Side Deficient in Growth

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