GOSS – Gomez Orthotic Spine System
The Gomez Orthotic Spine System is a unique method for the conservative treatment of spine deformities that stresses the importance of overall spinal balance and stability. It utilizes a thorough clinical evaluation of the deformity and the flexibility or correctability in all 3 planes. A computer aided design (CAD) program is used to develop the patient’s new 3D shape or correction.
Other systems rely on traditional plaster casting of the patient and blueprinting of their coronal x-ray. CAD programs now make it possible to modify patient’s shapes in all 3 planes.
We provide the following services on a referral or consultative manner:
- Specialist Spine Consultation
- Halo Brace
- CO (Cervical Orthotic)
- CTO (Cervical Thoracic Orthotic)
- TLSO (Thoracic-Lumbar-Sacral Orthotic)
- Anterior and posterior opening
- One Valve or Bi-Valve
The use of CAD-CAM technology in the treatment of adolescent idiopathic scoliosis:
• The following is an introduction to a third CAD- CAM assisted approach developed by Dr. Miguel Gomez, of Bogotá, Colombia.
In introducing his approach, it is important to underscore that CAD-CAM should be seen as a single tool within the process and that the effectiveness of the bracing system is mostly dependent upon the experience and attention to detail on the part of the treating clinicians. Many of the principles introduced came from Dr. Gomez’s two decades of experience treating spinal deformities by traditional methods of hand casting and hand model rectification. However, the ability to apply these principles in a consistent, reproducible manner has been enhanced by the CAD technology.
• Inputs
Optimal use of a CAD-CAM based system requires multiple inputs. Each treatment plan begins with a careful evaluation of the patient’s deformity and in the coronal, sagittal and transverse planes documented by digital photography.
• Patient Measurements
As part of the clinical evaluation, over 25 anthropometric measurements are taken that include lengths, MLs, APs and circumferences as well as the geometry in all 3 planes.
• Flexibility
Flexibility of the spinal column is difficult to quantify, but important in predicting and ensuring maximal in-brace correction for each case.
• Balance Assessment
A final component to the patient assessment is careful observations of the patient’s overall balance. This is done in both the sagital and coronal plane and can be performed with the assistance of a laser level.
• Fitting
During the fitting appointment, accurate fit of the orthosis is verified. Trim lines are adjusted as needed to facilitate patient comfort and compliance.
• Follow-up
As with any spine bracing system, the effectiveness of the orthosis is ultimately verified radiographically. At this point, the clinician should verify that the results obtained by the orthosis are consistent with the flexibility of the individual curve, both with respect to the Cobb angles and decompensation.
• Outcomes
The bracing system described is currently being utilized at Texas Children’s Hospital in Houston Texas, the University of Oklahoma in Oklahoma City, Texas Scottish Rite Hospital in Dallas Texas, and Children’s Memorial Hospital in Chicago. The system has been in use for three years with positive preliminary outcomes. Long term outcome studies are underway.