AtlanticProCare - Prosthetic Limbs & Bracing            "We bring the best that the field has to offer         

              to Maine and if the solutions that you need 

              don't exist, we'll create them for you."

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Maine's Leader for the Treatment of Scoliosis

What is Scoliosis?

Scoliosis actually comes in several different forms but the most typical is referred to as Adolescent Idiopathic ScoliosisAdolescent because it appears in adolescents while the skeleton is still growing, usually at about 11-12 years of age; Idiopathic because although there has been some very interesting research in to the possible causes, the exact cause of this problem remains unknown.   In general however it is a condition where the spine curves as the skeleton develops.

Scoliosis X-rayScoliosis is typically characterized by an "S" shaped curve to the spine that is readily visible with an X-ray.

When observing your child the appearance can be much more subtle. Occasionally you might
notice that there appears to be a more prominent shoulder blade on
one side or a tilt to the head or even that their clothing may not
hang straight.

 

 

Any of these things is worth following up on with your pediatrician. You can also do something called the Adam's Forward Bend (or Diver's) Test to get a handle on the presence of a scoliotic curve.

 

Early detection and evaluation of scoliosis

The key to successful treatment of scoliosis is both identifying the problem early on and then determining if the curve is progressing (not all curves do).  Schools do a screening for scoliosis that is often very effective in picking up on early curves.  Following up with an orthopedic doctor who can do an in-depth radiographic (x-ray) evaluation is absolutely essential. 

 

When to treat scoliosis 

Treatment is usually indicated if there is both a documented progression of a curve (done with 2 successive x-rays) and if the curve reaches 20 degrees (an angle measured from lines perpendicular to the top and bottom vertebrae in the curve).  The problem is these curves can't be reliably measured without x-rays.  Unfortunately parents and even pediatricians will often take a "let's wait and see" approach and will inadvertently allow a curve to progress past the point where it can't be treated with anything but extensive surgery resulting in life-long impairment.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

These 2 X-rays compare the same child 4 months apart, note the significantly greater sweep to the spine-this is progression of the curve.

 

Scoliotic curves don't get better  

The critical fact of scoliosis treatment is that the curve doesn't reverse itself.  So, what ever the curve is when you start treatment, the best result that you can hope for will be to keep it from getting any worse.  A minor curve, less than 20 degrees, is something that most people can tolerate throughout their life with little or no appreciable discomfort or deficit.  This is why documenting the curve early and monitoring it for any progression (worsening) is so critical.  A "wait-and-see" approach can lead to disastrous, irreversible, results.

In-Brace Correction.   The goal of bracing is to decrease the curve while in the brace during your child's growth.  Studies show that if a curve can be reduced by about 50% and worn 20-22 hours a day while the skeleton matures, that there is an excellent chance that the curve progression will be halted.

 

 

 

 

 

 

 

 

 

 

These 2 X-rays compare the same child out of their brace (L) and in their brace (R).  Note how the curve to the left has been reversed by the forces that the brace creates.  The bright spots and rectangles on the in-brace X-ray are the metal in the straps used to hold the brace closed.

Scoliosis treatment in Maine  

We are fortunate to have several excellent orthopedic resources in our area for the treatment of Scoliosis.  One of the leading specialists is Dr. Phillip Anson of Falmouth Orthopedic.  In addition to specialization in many other aspects of orthopedic surgery, he is known for his extensive experience and his excellent results with both the surgical and non-surgical treatment of Scoliosis and is arguably the best in Maine.  We are proud to work extensively with Dr. Anson and have a close rapport with his office facilitating scheduling and coordination to make the logistics for you significantly easier.

 

What makes us the best? 

The most widely used treatment for scoliosis is the "Boston" brace.  This brace design has a long and well established track record going back decades.  Based on sound mechanical principles and a "modular" system, each brace is made for a child based on a particular curve and body type and is effective at limiting progression of your child's curve. 

 

At AtlanticProCare we have taken the Boston brace to the next level.  Recent studies have revealed interesting subtleties that can enhance the basic concept of the Boston brace and result in an even more effective design--we employ this new knowledge in every brace we develop.  Also, instead of using the modular system of body types and having your child's brace made by a central fabrication facility, each brace is made here in our extensive, on-site lab using advanced Computer Aided Design and Manufacturing techniques to actually sculpt an accurate model of your child's torso.  The result is exceptional function and comfortable fit that is more easily accepted by your child.

 

Other resources for the treatment of Scoliosis 

This is a serious issue to deal with for both your child and you.  If you wish to have more information to make sure that you are making the best decision or if you are just looking for a second opinion, their are other options as well.  The Shriners Hospital runs a screening program and offers free care to those who qualify.  Also Boston is home to the world renown Children's Hospital Boston which has an extensive program for the evaluation and treatment of Scoliosis.  We work with both of these hospitals and can provide orthotic care locally to avoid the difficulties of long distance care.   Another resource is the web; we would recommend either the Scoliosis Association or the Scoliosis Research Society sites as a great place to start.  Please see the section below regarding kid-friendly sites also.

Typical Time Table for Treatment of Adolescent Scoliosis.

Critical points  Ideal Time Frame
 Initial detection of curve  As soon as possible, sometimes as early as 6, 7 or 8
 Evaluation by your child's pediatrician or Primary Care Physician  Within 2 weeks
 Referral to orthopedic doctor, 1st X-ray taken  Within an additional 2 weeks
 Follow up with orthopedic doctor, 2nd X-ray taken  3 months after the initial visit
 If bracing is required- referral to AtlanticProCare  Within 1 week
 Development of brace with initial fitting and information on how to use the brace  7-10 days later
 Initialization period to allow child to get used to the brace  2 weeks
 Return visit to orthopedist for 1st in-brace X-ray  Within 3 weeks of the initial fit date
 Return to AtlanticProCare for evaluation of in-brace film  Immediately following orthopedist visit (bring your X-rays)
 Design, fit and effectiveness of brace is confirmed  Confirmed at this visit or modified as required
 Routine follow up with your orthopedic doctor as treatment progresses  Every 3 months
 Routine follow up at AtlanticProCare  Immediately after each orthopedic visit for adjustments and maintenance
 X-rays  Every 6 months (at every other doctors visit)
 Treatment time frame-overall  Until about 2 years post-menarche for girls, about 16 for boys
 Weaning process (night-only wear)  An additional 6 months past the above point
 Weaning process (night-only wear)  An additional 6 months past the above point

How we can help.   So you've determined that your child has a curve that requires treatment and your orthopedist has recommended bracing, what's next?  We provide the best, state-of-the-art, orthotic management of scoliosis in our area.  Our board certified orthotists will meet with you and your child to discuss the process, talk about what to expect, show you what a brace will look like and help your child design their own brace so that it becomes theirs.  We will clinically evaluate your child's x-rays and using the most up-to-date concepts we will design a brace that will be the most effective brace possible.  After we've fabricated your child's custom orthosis we will go through an extensive fitting process where we make any adjustments necessary to ensure the most comfortable and effective brace possible.

 

 

 

 

Making it ok for your child.  This is the key to success.  No matter who you work with or what treatment plan you utilize, ultimately it has to be ok for your child.  We want your child to be comfortable with the experience and to feel like the brace is theirs--it promotes a sense of responsibility and participation critical to good compliance and a successful course. 

 

To help them enjoy and own the brace, we offer many possibilities in term of color pattern or personalized transfers.  Here are just a few of the possibilities. 

 

Resources for kids.  Information and understanding can only help, if you want to sit down with your child and learn more about scoliosis there are some good sites out there.  We recommend spinekids.com or iscoliosis.com as places that they can learn about what's happening in their bodies, talk with other kids, play games, etc.

 

 

 

 

More questions?  Please be sure call us toll free at 1-877 538 8825 or email us if you have further questions or would like to schedule a no-charge initial consultation for your child.  We'd be happy to review their situation with you in detail.

 

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