Responses: Scoliosis initial In-brace X-rays
Ksenia Jowyk, Orthotic Resident
Description
Collection
Title:
Responses: Scoliosis initial In-brace X-rays
Creator:
Ksenia Jowyk, Orthotic Resident
Date:
1/17/2012
Text:
Thank you to everyone who responded.
The original post:
When are the orthopedic surgeons requiring intial In-brace xrays for TLSO treatment of adolescent idiopathic scoliosis? Do they require xrays on the day of the delivery of the brace? Two weeks after wearing the brace full-time? Four weeks after wearing the brace full-time? A different schedule? Different schedule for different types of TLSOs?
Your input is greatly appreciated! I'll compile and post the responses.
Responses:
1.Dependent on the particular physician. The docs that I worked with would have the patient back after brace delivery which would be anywhere from two weeks to a month for in-brace x-rays. Regards,
Mike
2.Two weeks after delivery. The patient should be wearing full time for at
least a week.
Matthew
3.Good morning,
My local docs usually order IB xrays about 4 weeks after delivery of TLSO, when patient should be have been wearing the brace full time 2-3 weeks. At least that is the plan.
Gretchen
4.I like to wait. I think it is important to have the patient relax into the brace. I also have them sleep in it the night before x ray and I always attend the x ray.Mike
5.The Rx following for the treatment of scoliosis it is really important, and you questions are really interesting. I will not response them, better I could recommend you to contact to an expert in this field, his name is Dr. Jose Miguel Gomez this is his contact <Email Address Redacted> please tell him about that questions and I an sure he will response them correctly.
Have a great day!
Martin
6.Our patients go anytime they can get an appointment with their doc after the day of delivery. About two weeks, but no specific time is required.
7.We generally have the pt. in the brace for at least two (preferably four)
weeks prior to in brace x-ray. That way they've weaned into full time use
and we've handled any fitting issues prior to the x-ray.
Christopher
8.Usually no X-Rays are taken the day of fitting there are couple of reasons for not to do that. Most Spine programs will have defined protocols for a post fitting follow appointment with the orthotist. In my experience with adolescent idiopathic scoliosis following these protocols an X-Ray is taken 4 weeks post fitting, prior visit with the orthotist that day to ensured the patient has the brace on tight enough and is fitting properly. Usually an AP and Lateral X-Rays are taken with the patient standing, long cassette, no shields, and no shoes or if a shoe lift was provided put it under the correct foot. Do you have the proper design? Does the brace have a positive effect on the spine? (Positive effect: is the spine balance, are the Cobb angles reduced) You should see that on the X-Ray.
Eddy
9.You will not seem much correction if the x-ray is taken same day as delivery of the brace. We schedule a 2 week follow-up after delivering a scoliosis TLSO. That gives the patient a chance to get used to the brace, allows the patient to tolerate the straps at proper tightness, and the spine becomes more flexible, which shows the amount of correction you are actually getting. If all goes well at the 2 week follow-up, they are sent to x-rays for in-brace films. If the brace is 24-hour brace (ie. Boston) the x-ray should be taken standing. If the brace is night time brace (ie. Providence) the x-ray should be taken supine.
10.We normally make an X-ray after approximately 4 weeks after wearing THE brace fulltime . That’s standard in the hospital where I work.
Stan van neer (Netherlands)
11.In the clinic I serviced, Xrays in the brace was done 4 weeks after
delivery. This was set up to allow the child to go home with the brace,
get used to it for 4 weeks and then be checked by the Orthotist before
they were xrayed or saw the Ortho doc.
It seemed to work well.
In a national study which I participated, the norm seemed to be 6 weeks
post fitting.
Good Luck,
Ed
12.I have found over the years that each physician has their own preference depending on where they trained. The physicians I work with typically want IB x-rays at 2 or 4 weeks post fitting. I think it is important to understand if they are looking for IB correction, pad placement, (depending on which orthotic design is prescribed). If IB correction is the goal than it would make sense to have the IB x-ray closer to weeks.
Tom
Ksenia MajorABC Board Eligible OrthotistPowell Orthotics and Prosthetics
(804) 649-9043
The original post:
When are the orthopedic surgeons requiring intial In-brace xrays for TLSO treatment of adolescent idiopathic scoliosis? Do they require xrays on the day of the delivery of the brace? Two weeks after wearing the brace full-time? Four weeks after wearing the brace full-time? A different schedule? Different schedule for different types of TLSOs?
Your input is greatly appreciated! I'll compile and post the responses.
Responses:
1.Dependent on the particular physician. The docs that I worked with would have the patient back after brace delivery which would be anywhere from two weeks to a month for in-brace x-rays. Regards,
Mike
2.Two weeks after delivery. The patient should be wearing full time for at
least a week.
Matthew
3.Good morning,
My local docs usually order IB xrays about 4 weeks after delivery of TLSO, when patient should be have been wearing the brace full time 2-3 weeks. At least that is the plan.
Gretchen
4.I like to wait. I think it is important to have the patient relax into the brace. I also have them sleep in it the night before x ray and I always attend the x ray.Mike
5.The Rx following for the treatment of scoliosis it is really important, and you questions are really interesting. I will not response them, better I could recommend you to contact to an expert in this field, his name is Dr. Jose Miguel Gomez this is his contact <Email Address Redacted> please tell him about that questions and I an sure he will response them correctly.
Have a great day!
Martin
6.Our patients go anytime they can get an appointment with their doc after the day of delivery. About two weeks, but no specific time is required.
7.We generally have the pt. in the brace for at least two (preferably four)
weeks prior to in brace x-ray. That way they've weaned into full time use
and we've handled any fitting issues prior to the x-ray.
Christopher
8.Usually no X-Rays are taken the day of fitting there are couple of reasons for not to do that. Most Spine programs will have defined protocols for a post fitting follow appointment with the orthotist. In my experience with adolescent idiopathic scoliosis following these protocols an X-Ray is taken 4 weeks post fitting, prior visit with the orthotist that day to ensured the patient has the brace on tight enough and is fitting properly. Usually an AP and Lateral X-Rays are taken with the patient standing, long cassette, no shields, and no shoes or if a shoe lift was provided put it under the correct foot. Do you have the proper design? Does the brace have a positive effect on the spine? (Positive effect: is the spine balance, are the Cobb angles reduced) You should see that on the X-Ray.
Eddy
9.You will not seem much correction if the x-ray is taken same day as delivery of the brace. We schedule a 2 week follow-up after delivering a scoliosis TLSO. That gives the patient a chance to get used to the brace, allows the patient to tolerate the straps at proper tightness, and the spine becomes more flexible, which shows the amount of correction you are actually getting. If all goes well at the 2 week follow-up, they are sent to x-rays for in-brace films. If the brace is 24-hour brace (ie. Boston) the x-ray should be taken standing. If the brace is night time brace (ie. Providence) the x-ray should be taken supine.
10.We normally make an X-ray after approximately 4 weeks after wearing THE brace fulltime . That’s standard in the hospital where I work.
Stan van neer (Netherlands)
11.In the clinic I serviced, Xrays in the brace was done 4 weeks after
delivery. This was set up to allow the child to go home with the brace,
get used to it for 4 weeks and then be checked by the Orthotist before
they were xrayed or saw the Ortho doc.
It seemed to work well.
In a national study which I participated, the norm seemed to be 6 weeks
post fitting.
Good Luck,
Ed
12.I have found over the years that each physician has their own preference depending on where they trained. The physicians I work with typically want IB x-rays at 2 or 4 weeks post fitting. I think it is important to understand if they are looking for IB correction, pad placement, (depending on which orthotic design is prescribed). If IB correction is the goal than it would make sense to have the IB x-ray closer to weeks.
Tom
Ksenia MajorABC Board Eligible OrthotistPowell Orthotics and Prosthetics
(804) 649-9043
Citation
Ksenia Jowyk, Orthotic Resident, “Responses: Scoliosis initial In-brace X-rays,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/233303.
