Detecting Scoliosis

Early detection of scoliosis

With regular observation of the child’s posture and back, parents can easily take the first step by comparing whether there has been a change in the spine. Usually the entire spine is affected in a scoliotic change. Sometimes a curvature occurs only in certain segments of the spine, i.e. only in the lower area (lumbar spine) or the upper area (thorax).

The so-called “Adams Test” enables parents to determine easily and effectively whether scoliosis is developing in their child. One of the most frequent indicators for that is the prominence of one shoulder blade – in this case usually the right.

Further indications are uneven shoulders (shoulder malposition) or the pelvis tilting to one side and appearing similarly uneven in the lumbar spine region. There is a noticeable elevation left or right on the spine and a flattening or indentation next to it.

Scoliosis early detection test

Standing in normal posture:

  • Are both shoulders even?
  • Is the head centered in a line (vertical) above the horizontal line at the crease from buttocks to bone (gluteal fold)?
  • Are the shoulder blades even and symmetrical or is one protruding outward?
  • Is one side of the pelvis higher than the other?
  • Are the spacings between the waist to the hanging arms the same on both sides?
  • Is the waist symmetrical on both sides?
  • Does the child stand leaning toward one side when in a normal posture?

The Adams Test

The Adams forward bend test is the safest method of clinically diagnosing scoliosis. The following steps are necessary to perform it:

  • The knees are stretched and, in a bent over position, the hands come together below the knees.
  • Do you see asymmetry (hump-rib hump) in the thoracic spine area? (Ribs, shoulder blade)
  • Are there asymmetries (elevation with an accompanying indentation) in the waistline or pelvis?

Note on medical precision

The tests described above serve to sensitive and support parents in observing changes in a child. They do not replace the diagnosis by a doctor. When physical changes – as described above – can be discerned in a child, he/she should be immediately examined by a doctor. We are happy to help in the search for experienced specialists.

Scoliosis treatment

Coping and interaction in daily life

When people, primarily young people, learn that they have scoliosis, the first understandable thoughts are often a general concern about possible consequences for a life with physical change or the effects of treatment.

Scoliosis patients are not alone

Those affected by scoliosis are not alone: Currently more than 40,000 young people living in Germany are scoliosis patients with a curvature angle of over 20 degrees.

Beginning scoliosis treatment early

When therapy begins promptly, scoliosis with a corset like the Ortholutions Original RSC® Brace is effectively treated. There is only one stage of life in which the progression of scoliosis can be effectively interrupted: the physical growth period.

Taking regular check-up appointments

In addition to the discipline involved in consistently wearing a scoliosis corset, regular visits to the orthopedic treatment team are important. Only then can necessary adjustments be made promptly and effectively. With the help of expert support, patients can actually do everything necessary for treatment in order to restrict the progression of scoliosis.

The Ortholutions Original RSC® Brace Scoliosis treatment system

Scoliosis treatment: Established process – The latest orthopedic knowledge

The Original RSC® Brace is produced using a patented process from Ortholutions. The treatment with the scoliosis corset encompasses a holistic treatment system, based on the Chêneau principles.

The established system is founded on the latest international scientific research and guidelines. The corset wear time as well as X-ray monitoring and check-ups are established in a treatment protocol.

The goals of the Original Ortholutions RSC® Brace Systems:
– Stopping the progression of scoliosis.
– Maintaining the mobility of the spine.
– Optimizing the cosmetic appearance.
– Maintaining and improving overall health.
– Increasing quality of life.

When is corset treatment necessary?

For a curvature of over 25° according to Cobb and less than Risser 4

  • Curvature over 45° Cobb and less than Risser 4, when surgery is rejected or when there are other factors involved.
  • For a curvature under 25° Cobb under close consideration of the risk of deterioration.

Cobb angles and Risser signs are indicators that are established by scoliosis experts prior to corset treatment with an Ortholutions Original RSC® Brace.

Wear times of the Ortholutions RSC® Brace

The wear times depend on certain parameters like the degree of curvature and age. There are three wear time variations:

  • Nights / night treatment (nt)
  • Partial time (pt)
  • Full time (ft)

Getting used to the brace

The individual wear times are determined after consultation with the orthopedic specialist team. Getting used to the corset occurs in three stages, which build on each other logically and functionally:

Phase 1: Nights –
Phase 2: nights + afternoons –
Phase 3: nights + afternoons + mornings.

Procedure and monitoring of medical progress

Check-in after 6 to 8 weeks

After achieving this first, defined wear time, there is a corset check to monitor the function, fit, corrective pressure and volume.
Then there is a scoliometer check of the surface rotation under consideration of the anthropometric data (body height, weight) using the ATR Tool (Angle of Trunk Rotation).
A clinical check of the surface topography using digital images in the frontal and sagittal plane and / or formetric images is useful. X-ray images in AP (from front to back) and sagittal (side profile) of the entire spine and the chest.

Check-up after 3 months
  • Corset check (monitoring of function, fit, and corrective pressure as well as volume and closures)
  • Anthropometric data ATR (surface rotation) using ATR Tool
  • Scoliometer surface topography / clinical check using digital images in the frontal and sagittal plane
Check-up after 6 months
  • Brace check
  • Anthropometric data
  • ATR (surface rotation) via ATR Tool, scoliometer
  • Surface topography / clinical check using digital images in the frontal and sagittal plane
  • X-ray image as needed

X-ray images – as few as possible, as many as necessary

The Ortholutions Original RSC® Brace treatment method prescribes X-ray images during a regular treatment course as follows in order to comparatively reduce the radiation exposure.

The first X-ray image occurs after 6 to 8 weeks in the corset – consequently within the framework of follow-up treatment. This means that an X-ray image without corset is generally omitted since the diagnosis and determination of the curvature pattern has already occurred at the beginning of treatment.

In this way, radiation exposure can be reduced by up to 50 percent as compared to other therapies.

This course and reduction of radiation dosage can only be maintained if a patient goes to all follow-up appointments and is clinically and expertly examined on a regular basis. If during clinical examinations deviations are noticed, X-ray images without corset may be necessary in order to determine the patient’s current condition and to adjust measures accordingly.

Starting point and therapy plan

In order to determine scoliosis therapy, an examination of the bone maturity is important before beginning treatment. This characteristic value, the so-called Risser sign, shows what spinal growth can still be expected and is established via X-ray. The main focus of the determination is the ossification stage of the iliac crests (ossification of the ilium apophyses).
An X-ray image of the left hand, the shape of the sex organs, menses for girls as well as the degree of puberty-induced vocal change in boys can be used for the iteration of maturity as well as that of the growth potential.

The Original RSC® Brace: Holistic scoliosis treatment concept beyond the corset

RSC® Brace model determination by scoliosis experts

  • The manufacturing of an Original RSC® Brace for scoliosis therapy occurs without plaster cast. All patients receive an individually produced scoliosis corset that is made from the unique and patented process from Ortholutions.
  • Every patient receives a model specific to his/her curvature, which is personally determined by Dr. Rigo using the comprehensive databank. Thus, many scoliosis patients benefit long-term from this established system.
  • Scoliosis patients receive their Original RSC® Brace directly at Ortholutions or exclusively at competence centers that are certified by Ortholutions only after intensive training.

Individual, customized, result-oriented

  • The Ortholutions Original RSC® Brace is made after measurement and a 3D scan – only that way can the fit be optimized. A better fit means more comfort. As a result, scoliosis patients can better tolerate the treatment (compliance).
  • This excellent fit of the trunk orthoses is an essential component of the scoliosis treatment with Ortholutions. The resulting realistic results are achieved only with a professional team, together with treating orthopedic specialists, orthopedic technicians and physiotherapists.

Scoliosis treatment with proven physiotherapy methods

  • All brace models of the system are originally modelled from the scoliosis expert Dr. Manuel Rigo.
  • The Ortholutions Original RSC® Brace System provides sophisticated basic modules that are guaranteed by biomechanical mechanisms of the proven scoliosis physiotherapy using the method of Katharina Schroth and the subsequent Barcelona Scoliosis Rehabilitation School (BSRS) concept from Rigo.

The Ortholutions Original Rigo® System Chêneau® (RSC®) scoliosis brace

Comprehensive, effective scoliosis therapy beyond the corset

  • Profiting from the unique scoliosis therapy network
  • Maintaining maximum treatment safety for scoliosis
  • Profiting from international research on scoliosis therapy
  • Experiencing continuous, professional care as a patient

Proven therapy for idiopathic scoliosis

The Ortholutions Original RSC® Brace is produced in a patented procedure for patients with idiopathic scoliosis.
The Ortholutions Original RSC® corset guarantees maximum treatment safety for patients with idiopathic scoliosis.
It is the advancement of the proven Chêneau® principles and is used as a supplement to scoliosis physiotherapy using the Schroth method or the Barcelona Scoliosis Rehabilitation School (BSRS) concept.

Most effective principle: Individual standard

The Ortholutions Original RSC® Brace is the functional evolution of the standardized biomechanical design for trunk orthoses for scoliosis treatment. The curvature-specific modules are based on the original Chêneau principles that were developed in the biomechanical sense based on physiotherapy knowledge of the scoliosis expert Dr. Manuel Rigo. The efficient Ortholutions model data bank is continually expanding, taking into account the most recent international scientific research on conservative scoliosis treatment.

Corset determination and diagnosis by scoliosis experts

Every Ortholutions Original RSC® Brace is individually made. For every patient, Dr. Rigo performs an individual diagnosis and corset determination. This is confirmed by a certificate for every scoliosis corset.

Delivery to certified treatment teams

The Ortholutions Original RSC® Brace is exclusively delivered to specialist companies / treatment teams, consisting of doctor, physiotherapist, as well as orthopedic technicians / CPO. Only appropriately trained and licenced partners can exclusively use the Ortholutions Original RSC® Brace for treatment.

Therapy implementation according to medical and scientific research

Treatment with the Ortholutions Original RSC® Brace is based on a specific treatment protocol that was developed according to international guidelines by leading scoliosis specialists in renowned bodies such as SOSORT (Society on Scoliosis Orthopaedic and Rehabilitation Treatment) and SRS (Scoliosis Research Society).

Transparent process of an Original RSC® Brace treatment

  1. Measurement of static and dynamic dimensions
  2. Collection and classification of data in the central Ortholutions database
  3. Classification and model selection by Dr. Rigo
  4. Production of the Ortholutions Original RSC® Brace
  5. Fitting and release to patient on site

Helpful collaboration of scoliosis patients and RSC® experts

The scoliosis corset users and their families gain service and safety using the Ortholutions Original RSC® Brace within the framework of a holistically designed scoliosis treatment. Regular interaction of the patients being treated with an Ortholutions Original RSC® Brace with experts is important. Together, the specialists of Ortholutions and the partners on site monitor all treatments and discuss improvements.

From a therapeutic and orthopedic technological perspective, there are three areas:

  1. Clinical and technical checks, evaluation of new treatments
  2. continuous education and information for the scoliosis patients
  3. Knowledge sharing between experts regarding new findings

Optimal results through constant information exchange

New findings from the individual conversations with patients and parents are discussed, categorized and used to determine further treatment steps. This continuous advancement is the most important systematic in scoliosis therapy, for the effectiveness is increased by the direct detail-oriented information exchange among experts.

Patients and their families are educated to address their own needs and the situation at hand. By having all questions that arise in the course of daily use and previous examinations personally addressed, trust ensues gradually in the treatment and its components of the Ortholutions Original RSC® Brace scoliosis treatment concept as well as in the manufacturer of the Original RSC® Brace.

Simultaneously, only the personal involvement of the user in the open and effective team collaboration of the Ortholutions Original RSC® Brace scoliosis specialists can create a cooperative atmosphere for the improvement of the patient’s health.

The sense of belonging to the overarching international RSC® Brace community lends additional weight to the decision for patients and family members and motivates them individually to be effective partners in the design of the undertaken treatment course.

Questions on scoliosis treatment

Frequently asked questions (FAQ) on using the Ortholutions Original RSC® Brace

− Information for patients –

How do I get used to the Ortholutions Original RSC® Brace?

In order to get used to your Ortholutions Original Rigo® System Chêneau® (RSC®) Brace, it is important to follow certain rules during the first weeks of treatment. Basically: Do not overdo it, but still strive to achieve the wear time necessary for you. In the beginning, the scoliosis corset is worn at night, then during the afternoons, and finally the mornings.

When you first get home with your Ortholutions Original RSC® corset, take time to put it on just as you were instructed.

After 30 to 45 minutes, take it off again.

You will put it on later when you go to sleep.

How can I sleep when I’m wearing the Original RSC® Brace?

There are three options for good night’s sleep, depending on how you are able to sleep:

  1. You sleep through the night. – Now it can occur that you feel tired. This is completely normal. The tiredness comes from the work that the many little muscles of the spine and between the ribs are doing to direct the chest and spine toward the corrective zones.
    This can sort of feel like muscle soreness. However, his effect should disappear again after a short time. – If not, please contact your orthopedic technician on site.
  2. You fall asleep and wake repeatedly at night. If you feel unwell or have any pain, take off the corset.
  3. You still can’t sleep after 1 ½ hours: Take off the corset.

What are the wear times with my Original RSC® Brace?

The wear times depend on the severity and type of curvature and your age. Your treatment team, which ideally consists of trained physiotherapists, orthopedic technicians and a doctor, will gradually increase your wear time with the help of these values.

How do I put on my Original RSC® corset?

If you put on your corset from the beginning correctly as often as possible, you will increase its effectiveness.  During the beginning stage of treatment (the first 1 to 2 weeks), it is useful to put on your Original RSC® Brace lying down.

– Why is that better?
Your spine relaxes in a supine position. You can enhance this condition by angling your legs so that the bending angle of your hip joints is ca. 80°.
It is easier for you to find the correct position in the corset when you are lying down. You can also very quickly learn about your body awareness, where the pressure zones of the corset must be and how the expansion spaces function.
Your scoliosis corset is much more effective when it is purposely positioned. Thus, it is important that you position your corset at the correct height. If it sits too low, it can lead to pressure pain on the iliac crests.

Where the pressure zones are and how your Original RSC® Brace functions can be explained by your orthopedic technician during the first fitting.

How can I clean the scoliosis corset?

You should regularly clean your corset. You can determine the frequency. A daily cleaning does not harm the corset. Ph-neutral soap (e.g. shower gel) is generally effective for this purpose. You can put some on a clean towel and wipe your Original RSC® Brace with it. For an especially thorough cleaning, you can even place your Original RSC® Brace in the shower and wash it off.

How do I care for and protect my skin?

You should always check the affected main skin areas when you take off your Original RSC® Brace or when you feel something unpleasant. That way you can prevent overstresses and injuries to your skin and the underlying tissue. The cleaning of the main skin areas in contact with your corset should occur daily. It is recommended that you use Ph-neutral soaps and shower gels for your daily body care.
If you use body lotion, ensure that the lotion is completely absorbed at the pressure zones of your corset and that your skin is dry. If it is too damp or greasy in these affected areas, your skin will not tolerate the effects as well, and this can lead to irritations.
The daily body care as well as corset cleaning are important because these processes can prevent unpleasant skin irritations when you sweat and produce body salts. Irritations can also be caused by the residue of aggressive cleaning solutions that are not properly rinsed out. In order to decrease the (over) sensitivity of your skin, there are special preparations and applications. Your orthopedic technician can recommend suitable options for you.

How can I ensure that my Original RSC® Brace is functioning?

In addition to cleaning your Original RSC® Brace, please check the extra padding and, if present, any customizations specially designed for you. The protective and corrective padding can sometimes detach and thereby limit the functionality of your brace. If they detach or are very soiled, you can have them replaced by your orthopedic technician. This also applies to the Velcro fasteners.

If the Velcro fasteners are soiled, they can no longer fasten the corset as effectively. Please ensure that they do not loosen while wearing the brace. You can extend the functional life of the Velcro fasteners by always fastening them even when you are not wearing the brace.

Why do I need a brace shirt?

Corset clothing, especially brace shirts are worn to protect the skin. They are seamless in the pressure zones and are made of especially elastic materials. The elastic materials of the corset shirts prevent clothing wrinkles from forming, since these can damage your skin through pressure and friction. Even if you wear the corset shirts, please always take care that no creases form.
There are particularly stylish corset shirts that protect you from the corset edges in the armpit area. These additional fabric pieces are called ‘axilla flaps‘.

How do I know when my Original RSC® Brace no longer fits?

  • There are suddenly pressure points on the bony protrusions or unusual spots.
  • The expansion spaces no longer provide enough space to breathe.
  • Your corset no longer overlaps – or it overlaps too much (during closure).
  • Your body height has increased more than 3 cm.

What is a pressure point?

Pressure points can occur in general while wearing an Ortholutions Original RSC® Brace. Some are reactive, an important visible indicator of whether and to what degree the corset is working. This cannot be compared to a mark left on your foot from a shoe’s laces or a reddened mark on the hips or abdomen that is visible when you remove your pants.

With regular wearing of your scoliosis corset, the affected skin areas, primarily in the holding and pressure zones, are usually reddened and can become somewhat darker. This is a result of a protective mechanism of the skin that reacts to the pressure of the corset so that you can better tolerate it. This darkening of the skin recedes at the end of therapy during the corset weaning phase.

If the reddened areas become very dark or abrasions on the skin surface appear, the corset must be adjusted.

Why are there expansion spaces in my Original RSC® Brace?

The expansion spaces (or expansion areas) of your Original RSC® Brace are an important and characteristic component. When you do physiotherapy using the Schroth method, you will quickly notice the effect. The Ortholutions Original RSC® Brace is constructed in such a way that you will be pushed into the expansion zones with every breath. This mechanism is achieved by blocking the movements in the curved position.

The unrestricted movement of your chest and spine in the expansion spaces must always be maintained. Doing physiotherapy using the Schroth method or the BSRS (Barcelona Scoliosis Rehabilitation School) concept, which originated based on the teachings of Katharina Schroth and Christa Lehnert-Schroth, is actually the optimum combination to correct your spine and chest.

How often should I go to corset check-ups?

Regular check-ups of your back and corset are very important for the success of your corset treatment. During the follow-up checks, your corset will be examined to determine what needs to be readjusted in order to optimize its use depending on growth phases or targeted corrections.

You will make these follow-up checks directly with your orthopedic technician. You should plan for a check-up with your technician at least every three months. This is particularly important during the main growth phase.

Your orthopedic specialist should also regularly observe the progression of the course of your treatment. There are effective methods today to monitor the spine without X-ray imaging.

What must I do to prepare the corset before an X-ray check?

During an X-ray check, it is important that your corset fits properly and is functioning. Please have your corset checked by your orthopedic technician prior to the X-ray. Small metal markings, visible on the X-ray, are usually made in order to check the various areas of your corset that are correcting your spine.

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