In September, the Scoliosis Research Society (SRS) held its 54th annual conference in Montreal, and Isico was there! The SRS annual conference is one of the most important international meetings devoted to scoliosis, and every year over 1700 research studies are submitted to the organisers for consideration. Despite this level of “competition”, one of the papers presented by Isico was, for the fourth year running, selected as the topic of an oral presentation, which was given by Prof. Stefano Negrini.

“Our research was very well received; in fact, interest in conservative treatments is growing all the time among surgeons” Prof. Negrini  remarked. “What our study showed was that degrees of curvature can be accurately predicted by combining clinical measurements of the hump: this not only reduces the number of X-rays patients have to undergo, but also the number of affected individuals who  go undiagnosed”.

During the conference, there was also discussion of mini-invasive surgical techniques. However, since there is, as yet, no short- or long-term evidence of the efficacy of these methods, their use is currently restricted to highly selected cases.

“This scientific society is ready to invest in research into the use of braces in children and adults” added Prof. Negrini. “The non-operative management committee suggested holding a course in Athens during IMAST, which is the second annual international congress organised by SRS, where Dr Sabrina Donzelli (an Isico physiatrist) and I will both be taking part as lecturers”.
Finally, this year’s SRS annual conference also saw Prof. Alberto Ponte, one of the world’s top ten scoliosis experts, presented with a Lifetime Award for his achievements, and this recognition was a source of great pride for us Italians! It was Prof. Ponte, of course, who developed an important technique for the surgical treatment of kyphosis (the Ponte osteotomy), which continues to be used in scoliosis surgery to preserve or restore the sagittal balance of the surgically treated spine.

“We couldn’t possibly have asked for a better piece of news than this to mark June, which is World Scoliosis Awareness month” commented Prof. Stefano Negrini, scientific director of Isico. “This recognition from Expertscape is a source of huge satisfaction not only for me but for the entire organisation I represent”.

Because while Prof. Negrini features among the world’s top 20 experts in the rehabilitation and surgical treatment of scoliosis (he is listed 11th to be precise: http://www.expertscape.com/ex/scoliosis), Isico finds itself in 38th place in the classification of clinical institutes. What is more, Prof. Negrini is not the only Isico specialist to appear in the classification: Drs Fabio Zaina (24th), Michele Romano and Sabrina Donzelli are also included.

Negrini’s ranking is based on 55 articles published since 2008.

What is Expertscape? It is an American rating agency that classifies the world’s leading experts in the various medical disciplines on the basis of the   analysis of a series of parameters and variables. With reference to the past 10 years, the site uses the National Institutes of Health PubMed database to identify and rank medical expertise across more than 27,000 topics.

The site was created to make it easier to find top specialists in any field of medicine. The site managers specify that they evaluate “scientific knowledge”; other criteria clearly cannot be taken into account in their evaluation, given that some of the top experts might be involved solely in research, and not in daily clinical practice with patients.

In the case of Isico, and its specialists, this recognition reflects the constant research and scientific publishing activity that accompanies their daily clinical involvement with thousands of patients.

Learn more about Expertscape’s methodology and how to increase your ranking.

“Ever since 2010, we at Isico have been using Thermobrace, a heat sensor that is applied to the brace in order to establish how much it is actually being worn. We see this as a way of fostering a better doctor-patient relationship, as well as a means of collecting real-life data that can be used to optimise the use of the brace”

explains Dr Sabrina Donzelli, Isico physiatrist and author of a study entitled “In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace”, published in the journal Scoliosis. “Our implementation of this heat sensor, which is the most suitable of those currently available on the market, has been a gradual process” she says. “Initially, we applied it to the braces of just a handful of patients, precisely because until recently literature opinion on the use of this kind of instrument was divided. We have actually found that it helps to strengthen the doctor-patient relationship, as it allows us to make therapeutic choices on the basis of real-life data obtained from the sensor, and these data can thus be used to optimise the use of the brace”.

The most surprising finding was that the patients who have the highest number of prescribed brace-wearing hours were the ones who showed the best compliance with the treatment. It emerged that 45% of the patients used the brace for the number of hours prescribed, or for just an hour less,  while 55% claimed to be wearing the brace for a number of hours that was very close to the actual number (a difference of 1 hour at most), and 60% showed 90% compliance.

Patients and parents tend to overestimate compliance, hence the reason for developing an objective assessment based on the use of heat sensors.

Whereas the authors of other studies set out only to verify actual compliance with the prescribed number of brace-wearing hours, our aim was to test the sensor as a tool for improving clinical practice. Accordingly, we have never used the sensor without a patient’s knowledge. We do not see Thermobrace as a means of “checking up” on patients, but rather as a tool for collecting real-life data that can be used to optimise treatments.

Indeed, these sensors enable doctors to be more precise as they endeavour to make the best clinical decisions. Along with brace quality and some disease factors, compliance is a key element in the efficacy of brace treatment: “In patients known to comply reliably with the treatment, we should be able to get a much more accurate idea of the true effectiveness of braces” added Dr Donzelli.

From 14 to 16 June, Michele Romano, our director of physical therapy, held a SEAS I course in Novi Sad. The event was our first in Serbia and it attracted over 20 participants, coming not only from Serbia, but also from Croatia, Israel, the Netherlands, North Macedonia and Montenegro.

Novi Sad was also the venue, on 29 June, for the ScoSym International Symposium on “Current Trends in Research on Scoliosis and Other Spinal Deformities”, where Romano was an invited speaker and gave a talk on the topic of sport and scoliosis.

Finally, at the end of July, Romano will be on the move again, flying to China to lead the last SEAS courses before the summer break. These will be held in Shanghai and Zhenzhou.

Isico will be at the forthcoming ISSLS Annual Meeting in Kyoto (June 3 to 7), a training event of the highest scientific and cultural level aimed at those dealing with spinal disorders. 

Founded in 1974, the International Society for the Study of the Lumbar Spine (ISSLS) is a non-profit organisation whose purpose is to bring together those individuals, throughout the world, who, by their contributions and activities both in the area of research and clinical study, have, or are developing, an interest in the lumbar spine in health and in disease.

With just 260 members worldwide, it is an exclusive society in which Isico is represented by Prof. Stefano Negrini as a member since 1997 and Dr Fabio Zaina since 2010. These two specialists will present different studies in Kyoto: Prof. Negrini will be giving an oral presentation (Identification through movement analysis of chronic low back pain pathological spinal movement patterns and their sensitivity to change during exercise treatment) and presenting a poster, and Dr Zaina will also be giving a poster presentation. In addition, both appear as co-authors of other posters being presented at the event.