For patients with scoliosis, it can be difficult to understand the different treatments on offer. The good news is that there are alternatives to invasive surgery.
Scoliosis is a condition where there is an abnormal curvature of the spine. It is a three-dimensional condition with deviation of the vertebrae in the sagittal, coronal and transverse planes.
The simple answer is no. Scoliosis is not hereditary; there is no single known gene responsible for the condition.
Most of the patients LOC see have what is termed idiopathic scoliosis, which means that there is no known medical cause for the condition. What we do know is that scoliosis tends to occur during periods of rapid body growth and adolescents account for over 80% of all diagnosed cases in children.
There are visual clues that a parent should be aware of:
Scoliosis affects 2 to 3% of the population. According to the NHS, around three or four in every 1,000 children will require treatment for scoliosis. It is most typically seen in children between the ages of 10 and 15.
Kyphosis is an excessive curvature of the spine that causes the top of the back to appear more rounded than normal. It can occur at any age but is common during adolescence. The condition is sometimes known as 'round back'.
Bracing can provide pain relief for those suffering from kyphosis by adjusting the position of the shoulders and pelvis. In the growing patient, we can prevent the worsening of the deformity and quickly improve appearance.
In terms of an official diagnosis, scoliosis is confirmed with an X-ray, which is typically followed up with an MRI scan. A key determining factor that is used when recommending treatment is what is known as the Cobb angle. This was invented by Dr John Cobb in 1948.
It is now the standard measurement to determine and track the progression of scoliosis. A Cobb angle describes the degrees of deviation from straight in the spine. This can be measured by our clinicians, so please feel free to send x-rays to us for assessment.
Yes, unfortunately it can. The more growing a child with scoliosis has to do the greater the chance their scoliosis will get worse. A 2017 study found that children with curves of 21-30 degrees had a 72.5% risk of progression to curves in excess of 45 degrees (therefore requiring surgery).
The optimal age for treating scoliosis depends on various factors, including the severity of the curvature, the skeletal maturity of the individual, and the specific type of scoliosis. In general, the earlier scoliosis is detected and treated, the better the bracing treatment outcomes.
Childhood and adolescence are critical periods for addressing scoliosis because the spine is still growing. Conservative treatments such as bracing or physical therapy are more effective when started before the skeletal maturity is reached.
Once a person reaches skeletal maturity, which is usually around the age of 16 to 18 in girls and 18 to 20 in boys, the bones have stopped growing, and it becomes less likely that scoliosis will progress. However, even after skeletal maturity, treatment options may still be considered, particularly if the curvature is severe and causing symptoms.
While treatment options are slightly more limited with age, we have had success treating adult patients.
In some cases, surgical intervention may be considered for adults with scoliosis, especially if the curvature is causing pain, difficulty breathing, or other health issues.
Treatment recommendations are based on the Cobb angle of the patient and the risk of progression. For curves under 20 degrees, we monitors the patient’s curve while the patient undertakes a tailored exercise programme based on Schroth principles; this is delivered by our partner in providing scoliosis treatment Scoliosis SOS.
For curves above 20 degrees, LOC prescribes its LOC Scoliosis Brace which works three-dimensionally to guide the patient’s spine into a more correct position, substantially reducing their Cobb angle. For optimum correction, we recommend that bracing is combined with specialist physiotherapy.
This joint approach means our patients are getting the best and most appropriate advice from two scoliosis specialists, one with an orthotic perspective and one with a physiotherapy perspective.
Yes, conservative bracing is a well-established treatment for scoliosis, particularly in adolescents with moderate curves. There is also excellent scientific evidence that full-time bracing treatment reduces the risk of patients requiring surgery.
The effectiveness of the brace depends on factors such as the patient's age, the severity of the curvature, and adherence to the treatment plan. However, severe curves (with Cobb angles over 40 degrees) may need spinal surgery to correct.
Braces like the LOC Scoliosis Brace:
For adolescent patients, scoliosis bracing can prevent a scoliosis curve from progressing, or getting worse, until they have stopped growing. In turn, this can help alleviate pain, discomfort and improve posture in the long term.
One of the main benefits of bracing is that it can help patients avoid invasive spinal surgery and all the risks that serious surgery carries.
As adults have reached skeletal maturity and the vertebrae are no longer malleable, an orthotic brace is unlikely to be able to correct the existing Cobb angle of the patient. However, LOC prescribes bespoke back braces to reduce posture-related pain and improve appearance and posture.
We are pleased to offer a free-of-charge, virtual assessment should you wish to be screened for scoliosis. If we feel a referral to an Orthopaedic Consultant is warranted, we recommend a consultation at The Wimbledon Clinic, Parkside with Mr Darren Lui, Mr Jason Bernard or Mr Tim Bishop. The consultant would arrange the imaging as required. You can also seek advice from your family GP.
The LOC Scoliosis Brace is a 3D, hypercorrective, Cheneau-Gensingen derivative brace, known as one of the most corrective and modern scoliosis braces available in the UK. It is designed to:
The brace is entirely unique and tailored to the patient’s spinal curve pattern, ensuring optimal skeletal correction while prioritising comfort.
Unlike traditional braces, it opens from the front for easier self-application and maintains a low profile under clothing.
The LOC Scoliosis Brace is worn 22 hours a day (including nighttime) and works in conjunction with Schroth-based therapy for maximum results.
The London Orthotic Consultancy is one of the most experienced private scoliosis clinics in the UK. Our clinical findings demonstrate an average in-brace correction of 85%. This compares with Boston braces which achieve 50% and other asymmetric braces available in the UK which achieve between 50 to 65%.
The hypercorrective nature of the LOC Scoliosis Brace enables it to push the curve(s) beyond the midline of the spine. This means we can achieve successful results with both simple single and complex double curves.
While outcomes vary from patient to patient, we have achieved success in a variety of age groups. From juvenile patients to adolescent and adult scoliosis patients.
Many patients can benefit from a bespoke LOC Scoliosis Brace, including:
The LOC Scoliosis Brace is typically recommended for the treatment of Cobb angles from 25 to 60 degrees. It is suitable for patients of all ages and is designed bespoke to your specific requirements.
The brace is made of hard plastic and has foam pads attached to the pressure points. It is flexible enough to bend slightly and is fastened with Velcro straps at the front.
Yes, we typically recommend the brace is worn for 22 hours a day for the initial 6 weeks of treatment and can then be reduced after that.
The more time you spend in the brace, the more likely the scoliosis curve will be stopped and you will see an improvement in your Cobb angle.
Yes. Thanks to the three-dimensional nature of the LOC Scoliosis Brace, we expect to see postural improvements within two 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 centralised over the pelvis following treatment, the patient’s overall prognosis is much improved.
LOC makes the vast majority of orthotics we fit, and our scoliosis brace is no exception. It is difficult to over-emphasize how important it is to have our own manufacturing unit on site. Lead times are shorter because we are not reliant on outside suppliers, and we can fine-tune our braces at the fitting stage to ensure optimum efficacy and comfort.
When attending your scoliosis appointment, we recommend you wear comfortable clothing that allows the clinician to easily assess your spine and perform necessary examinations. To allow for a successful consultation, you will be required to remove some clothing so that your clinician can examine you and take photos of your back. Here are some recommendations:
Wear loose-fitting clothing that can be easily removed or adjusted. This ensures that your orthotist can access and examine your back without any restrictions.
Go for comfortable bottoms, such as leggings or tracksuit bottoms. This choice allows you to move easily during any physical examinations that may be part of the assessment.
If you have long hair, consider bringing a hair tie to keep your hair away from your back during the examination.
Remember that the specific requirements may vary depending on the type of examination you are scheduled for. If you have any doubts about what to wear, you can contact the clinic ahead of time and ask for guidance.
Typically, there is an initial consultation followed by a fitting appointment and then pre- and post-reviews after in-brace x-rays; thereafter reviews every three months until the end of treatment. For the majority of our patients who are adolescents, we believe that regular assessments and reviews are essential to ensure that the brace fits well and patients achieve the best treatment outcomes.
During these appointments, we can make tiny adjustments to the brace to ensure optimum comfort and optimum correction. We have found that comfort is a major contributor to an individual’s compliance with the prescribed wearing regime. In addition, the close contact between patient and clinician ensures patient motivation resulting in better outcomes at the treatment end.
LOC understands that time is of the essence, particularly for newly diagnosed adolescents where the scoliosis curve can get worse quickly; we now offer same-day service – a new patient can be assessed and fitted with a bespoke brace on the same day.
