Treatment
Treatment Plan
Normally provision of The LA BraceTM requires 3 visits:
1) An evaluation appointment;
2) A fitting appointment; and
3) A follow-up adjustment appointment.
First Visit
On your first visit to The LA Brace Center, you are seen for evaluation. Here we review your history, your x-rays and your physical spine alignment. We will discuss the brace treatment and explain what we are trying to achieve and why it is necessary and discuss your probably prognosis. At this appointment we will take the information and measurements necessary to process the AGP data acquisition phase of the CAD development.
After your first visit, we work on creating your AGP data acquisition file, creating your CAD virtual model, carving your physical modeling and then making the brace.
Second Visit
On your second visit to The LA Brace Center, you are returning for the fitting of your LA BraceTM. We will fit the brace to you and review the fitting to make sure it is pressing in the correct areas and appears to be fitting correctly. We design The LA BraceTM to attempt to position your body in such a way as to generate the 3-Dimensional realignments needed. Hence, initially we expect your body will resist the pressure forces applied to it and the brace will tend to sit away from your body. Typically we will make a few small adjustments to the brace at this fitting appointment to ensure it is fitting optimally. At this point, we will show you how to put your brace on and discuss the recommended wearing schedule.
Ideally there will be a 2-week gap between your second (brace-fitting) appointment and your third appointment, to allow your body sufficient time to adapt to the pressures of the brace, to loosen up and for you to build up the wear time.
Third Visit
On your thirds visit you will return with your brace for review of your progress and to adjust the brace for optimal alignment. If everything is going to plan then we will seen that your body has loosened up and has begun moving into the void areas of the brace. At this appointment we are now focused on making sure the brace is realigning your spine into an improved alignment. After re-tightening the brace to accommodate your loosening, we will review your spine position and if necessary make further adjustments to the brace. We will also at this point review your brace with respect to Schroth treatment to see if any “Schroth holes” need to be added.
Remote Evaluation and AGP
To accommodate our “out-of-town” clients, we have developed a unique proprietary system to minimize your travel costs and time. The consistency of our AGP data acquisition system along with the availability of Skype video conferencing now allows us to do a remote evaluation. We will still make you an appointment for your evaluation but you will stay at home for this appointment and will only need a computer with an assistant (usually a parent), a video cam and an internet connection for us to remotely connect with you and perform the evaluation. In advance of this appointment we will need to ship you our remote AGP kit which you will use to create 3 jpeg pictures that you will email to us along with a picture of your x-ray. Therefore to do a remote evaluation we will need to (i) schedule your appointment; (ii) ship you the remote AGP kit and instructions and (iii) receive your jpeg pictures.
We have therefore devised the following alternative treatment plans that minimize your travel time and costs associated with receiving your LA BraceTM
ALTERNATE A – 2 trip
First Visit
Your evaluation is done remotely so your first visit to The LA Brace Center is for the fitting of your brace.
Second Visit
Your second visit with Plan B is for the follow-up adjustment appointment, approximately 2-weeks later.
ALTERNATE B– 1 trip
Our Plan C requires for you and your family to stay four days in the Los Angeles area. As with Plan B the evaluation is done remotely so on your first visit to The LA Brace Center we will be fitting you with your LA BraceTM. However we then give you a faster wearing schedule so that we can see you for your follow up adjustment appointment sooner. You will therefore be seen for the fitting of your appointment on the first day and after that you will have two days free to spend time enjoying your stay in Los Angeles (see What to Do while in L.A.). Then on your fourth day you will return for your follow up adjustment appointment.
Follow Up Care
Until you reach skeletal maturity and the risk of progression has diminished, your scoliosis can continue to develop if left insufficiently treated. It is therefore important to be seen on a periodic basis to review your status. Follow-up visits can be from every 3 months to every 6 months depending on how well stabilized the scoliosis correction appears to be. During your follow up visits we will review your posture and alignment in and out of the brace to assess your progress. We will also review any new full spine x-ray to determine if changes are needed to your brace and/or posture/exercise program. We will also review your brace for any possible refurbishment requirements.
For our out-of town clients, to minimize travel time and cost, we recommend that you alternate between remote follow-up appointments and visitation follow-up appointments, thereby minimizing your visits to The LA Brace Center to once every 8-12 months.
When brace adjustments are needed, the brace can be shipped to The LA Brace Center where we will make the necessary changes and then ship back to you.