Prof. Negrini awarded at the SRS congress

Prof. Negrini awarded at the SRS congress

The SRS congress that took place in Bologna at the beginning of October has seen Isico at the forefront, primarily with the awarding of the prestigious John H. Moe award to Prof. Stefano Negrini, Isico’s scientific director, for the best research poster titled Paravertebral muscles show double-cross activation but also in single AIS curves, with a corresponding oxygen consumption: an electromyography and a near-infrared spectroscopic study, realized in collaboration with the University of Brescia and the Don Carlo Gnocchi Foundation.

A remarkable recognition for those involved in conservative treatment within a congress composed for the most part by surgeons.

“There is a growing interest in conservative treatment – explains prof. Stefano Negrini. Also Dr. Sabrina Donzelli has been invited to be part of the committee dedicated to conservative treatment which I am part of since three years. We were pleased by the intention of the SRS to support studies that compare different braces. The congress allowed us to meet researchers and representatives of important research institutes with whom we laid the foundations for future collaborations. In Isico, thanks to constant data collection through clinical software, we have a very large database of patients eligible for different possible studies with important research institutes “.

During the congress several interesting studies were presented: from those on the use of lateral flexion radiographs to those on new methods for estimating residual growth using different evaluation methods that also include humeral cartilage, so as to understand how to better estimate the period of the highest evolutionary risk.

Finally, Dr. Sabrina Donzelli, physician of Isico presented the study Brace Wearing Time is the Strongest Predictor of Final Results: A Regression Model in 1457 High Risk Consecutive Adolescents with Idiopathic Scoliosis: “We evaluated a large number of patients treated with braces and we verified that the number of wearing hours is the primary predictive factor of the final result of the therapy – comments Dr. Donzelli “.

Brace wearing: tenacity repays with improvements

It is not just a question of how many hours the brace is worn but also of patient compliance with the prescription. Take, for example, Marco and Ginevra. Both have idiopathic scoliosis, are followed by Isico specialists, and wear a Sforzesco brace for 20 and 23 hours a day, respectively. Marco complies with the prescription of wearing the brace, but he is inconsistent with the prescribed hours: sometimes he wears it for the 20 hours prescribed, others for 10, and others for 22. Ginevra instead regularly respects the prescription of 23 hours daily; this allows her to attain better results and to avoid worsening.

This is demonstrated by our study, Consistent and regular daily wearing improves bracing results: a case-control study, just published in the journal Scoliosis and Spinal Disorders. The study considered 168 patients who wore a brace for between 18 and 23 hours per day, divided according to high, medium, or low compliance and classified according to consistency or inconsistency in wearing. The data were collected through the use of Thermobrace, a temperature sensor applied to the brace to monitor its actual wearing.

Isico was the first organization to introduce Thermobrace into the daily clinical routine in 2010, and since then, its use has become commonplace. It has been verified that the relationship between doctor and patient is strengthened through the use of Thermobrace, since the therapeutic choices are based on real data; therefore, the data obtained from the sensor can be used to facilitate the use of the brace.

“The data confirmed that the brace should be worn consistently, which means that wearing the brace for a constant number of hours allows the achievement of good results,” explains Dr. Sabrina Donzelli, physiatrist and author of the publication, “also for those who are not completely compliant to the prescribed hours”. This confirms what we always recommend to patients who undergo brace therapy: the break must always be constant; less hours one day and then recovering the lost hours in the following days is not ideal!”

Patients who, in addition to not adhering to the prescribed treatment, are also not consistent in wearing the brace are at greater risk of worsening. Patients who have worn the brace for less than 70% of the prescribed duration are considered non-compliant. “The study shows that to achieve the best results, the brace must be worn for a consistent number of hours, the attempt to recover lost hours is useless,” concludes Dr. Donzelli “While tenacity together with compliance, i.e., the adherence of the patient to the prescription, are rewarded”.

SRS 2018 in Bologna: ISICO will be there, too!

SRS 2018 in Bologna: ISICO will be there, too!

ISICO will be present at the International Congress of the SRS (Society of Research on Scoliosis), to be held in Bologna from 10 to 13 October.

SRS, founded in 1966, is the oldest scientific society for the treatment of scoliosis. ‘We will present the study, Brace -Wearing Time is the Strongest Predictor of Final Results: A Regression Model in 1457 High Risk Consecutive Adolescents with Idiopathic Scoliosis – Dr. Sabrina Donzelli says – We evaluated a large number of patients treated with braces and we verified that the number of hours of brace-wearing was the primary predictive factor of the result. We thus demonstrated that the high dosage of wearing protects more and should be raised proportionally to the severity of the curves’.
Furthermore, Prof. Stefano Negrini, ISICO’s scientific director, will talk about brace therapy and patient compliance in a special session, Current trends in bracing for AIS, while we also will have the opportunity to present the preliminary results of the first phase of research (two years) on the Scoliosis Natural History funded by the SRS itself, aimed at identifying a predictive model about the evolution of scoliotic curves in untreated patients.

Eurospine 2018: ISICO will present two studies

At the International Eurospine Congress in Barcelona, 19 to 21 September, Dr. Fabio Zaina will present a poster titled Adolescent idiopathic bracing success rates influenced by time in brace: Comparative effectiveness analysis of the BrAIST and ISICO cohorts, while Dr. Francesca Di Felice will deliver an oral presentation about the study, ISYQOL discriminates adolescents with spinal deformities subgroups better than the SRS-22 questionnaire.

‘The first presentation confirms the effectiveness of the brace treatment for patients with adolescent idiopathic scoliosis at high risk of progression, the efficacy being highly linked to the brace-wearing dosages,’ explains Dr. Di Felice. ‘The final results obtained with the protocols of the ISICO treatment are excellent, also with respect to the data of the BrAIST, the American RCT study which had and has a huge weight in demonstrating the efficacy of the conservative treatment of scoliosis.’
The other study emphasizes how a questionnaire developed in ISICO, the ISYQOL (Italian Spine Youth Quality of Life questionnaire) has proved to be the best quality of life measurement tool for patients with vertebral deformities treated with conservative therapy, compared to the SRS-22, which is currently the gold standard of the quality of life questionnaires for scoliotic subjects.

Sosort Congress: Isico in front row

Sosort Congress: Isico in front row

There was a massive presence of ISICO specialists at the 13th edition of the International Congress of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) which took place in Dubrovnik, Croatia from 19–21 April.

Over 250 specialists from 38 different countries were present over the various days, while 200 participants took part in the pre-courses, one day prior to the official congress with the topic being clinical approach and research.

“We have presented seven different research papers, for sure we were the group with the largest number of studies”, said Dr. Fabio Zaina, ISICO specialist and SOSORT Past President, “and we were also nominated for the SOSORT Award. Our research concerning the quality of life of braced patients has attracted great interest, a quality that has been measured through the questionnaire we normally hand over in ISICO to our patients. The questionnaire was translated into English and Spanish for this congress and its use is also going to be spread abroad now.”

Among the studies presented we also received positive feedback for our study on scoliosis and adults that showed how the exercises can give results on pain management, for the study with the topic of back pain in children, and for the one that highlighted how sports can have positive effects on scoliosis.

During the congress, our technical director Dr. Michele Romano, passed the baton of presidency to the new president of SOSORT, Luca Stikeleather from the USA, the first orthopedic technician to take on this task.

New Guidelines

A systematic review of all scientific literature published by leading experts on the treatment of scoliosis led to the recent publication in the journal Scoliosis and Spinal Disorders of the new international guidelines drafted by the International Society for the Treatment of Scoliosis (SOSORT). The previous review was conducted in 2011, while the first publication dates back to 2005.

Among the 21 authors, from countries such as the United States, Canada, Japan, Germany, Spain, France, Poland, Greece, ISICO represented the largest group with Prof. Stefano Negrini, Scientific Director of ISICO, Dr. Fabio Zaina, Dr. Sabrina Donzelli, and Dr. Michele Romano, Technical Director of ISICO.

“We started from a review of the studies on everything related to the subject of scoliosis, from definitions to therapeutic goals and from the examinations to be carried out, to exercises, to braces and lastly to screening”, explains Dr. Sabrina Donzelli, physiatrist at ISICO, among the authors of the guidelines, “in this way, starting from the available scientific evidence, therapeutic recommendations have been elaborated, summarized in tables, which represent a fundamental tool able to guide the clinician in the ideal therapeutic choices for each patient.”

Tables are an important tool in the treatment of scoliosis as they allow the definition of therapeutic levels with respect to the age or entity of the pathology, e.g. the treatment can range from simple observation of minimum curves to the recommendation to wear a brace for up to 24 hours.

“It is a document of great importance for all professionals in the treatment of scoliosis”, continues Dr. Donzelli, “available online, in English, useful even for patients and their families. Considering the immense amount of work that is behind the guidelines, it was decided to divide in the future next editions into sub-chapters, for example scoliosis in adults, braces only, or exercises only.”

“To conclude, I would like to underline that the recommendations of the guidelines”, Dr. Donzelli tells us, “must always be accompanied by the experience of the professional team, from the doctor to the orthopedic technician, as scoliosis is a complex pathology. The guidelines recommend that scoliosis should always be treated by experienced professionals. The experience of each professional is defined by a minimum number of visits and patients that must be visited/treated each year. The guidelines also recommend using therapies in which one is skilled in order to guarantee better patient management and promote therapeutic success.”