We are a CCS-paneled provider. For other insurance plans, we currently operate as an out-of-network provider. Please note that we do not require or accept insurance for our services. However, we do offer payment plans to make our services more accessible, and we can provide a superbill that patients may submit to their insurance for potential reimbursement.

Please see the resources on our Scoliosis and Cheneau Braces

The office can be found at 15478 Ventura Blvd. Sherman Oaks, CA 91403

We treat patients with mild, moderate, and severe scoliosis of varying curve patterns. Ray has treated patients with scoliosis Cobb angle(s) starting at 10° and up to 95°. Our patients with kyphosis typically have thoracic Cobb angles ranging from 50°-85° (as measured on a lateral spinal x-ray). We pride ourselves on taking a proactive approach to treatment while others are ‘watching and waiting.’ That said, it’s never too late to improve quality of life, help with pain management and halt further progression.

During the initial examination, girls should bring a sports bra with maximum

exposure to the back, while males will be shirtless. For bottoms, any comfortable

pants/shorts are acceptable. During the brace measure, a 3D scan is taken. Tight

fitting bottoms are required to not add extra width to the body (something similar to spandex bicycle shorts is best). During brace fittings, a snug, long t-shirt is required to wear under the brace (seamless if possible).

All patients must have a recent full spine X-ray before their appointment. We do not take X-rays in the office. If you do not have recent X-rays, I can refer you to a local imaging center. In-brace X-rays will also be needed to check fit and correction before the final fitting.

In-brace correction is the amount (in Cobb angles degrees or as a percentage) that the Cobb angle(s) decreases, as demonstrated by x-ray, while the patient is wearing their brace. This will depend upon several factors: age, curve pattern, spinal stiffness, trunk shift, and brace fit.

First, let’s consider improvement. Regarding conservative scoliosis management, progress may be experienced in various ways–Cobb angle reduction, prevention of Cobb angle progression, postural/visual improvements, pain reduction, etc. Regarding Cobb angle and scoliosis, an improvement is considered a reduction of more than 5º as measured on an x-ray. This is because Cobb angle measurements can be subjective and vary according to the time of day taken or equipment variation. Curve reduction is NOT guaranteed because each patient is unique. The difference in age at diagnosis, curve severity, growth potential, curve flexibility, compliance to the program, etc., play a role. Not every adolescent patient will see curve improvement, although most of our patients do experience improvement in some way, shape, or form. After just a few days of instruction, many adolescents have experienced increased pulmonary function.

Postural improvements can start to show for most patients after a couple of months of consistent exercise. Some patients take longer to see results. Each patient’s body and response are different. The key is consistency and patience. Some adult patients have had pain relief right away, a reduced incidence of headaches, and other symptoms when it comes to pain.

Research shows that when an adolescent reaches skeletal maturity with a Cobb angle of 30 degrees or less, progression into adulthood is less likely. Bracing is recommended for rapidly progressing curves in growing adolescents, and timing is often critical.

For adults, bracing is not typically used to reduce the Cobb angle but can help with pain relief, posture, spinal support, and slowing further progression.

Growth is unpredictable, so the number of braces needed for a growing child will depend on age, stage, and pace of growth. Growth may require a second brace or more. Feedback from parents and children and follow-up photos and x-rays allow us to know when it is time for a new brace or brace adjustments.

Yes. While adults should not expect a reduction in Cobb angle from bracing, many report improvements such as pain relief, better posture, and increased spinal support. Bracing can also assist in managing progression and improving daily function.

When patients are braced, follow-ups are necessary except in some

circumstances when the child or adult patient is at skeletal maturity. As the body

changes with growth or as a result of improvements due to bracing and exercise,

padding can be amended for comfort or increased for an extra push to try and

enhance results. if a patient has outgrown the brace (typically at a growth of 5cm

in height) or has increased girth, a new brace will be necessary to avoid loss of

correction and unintended consequences. regular check-ins allow us to monitor

growth.

The recommendation for bracing for scoliosis is dependent upon one or a

combination of factors, including age, Risser sign, Cobb angle(s), and

estimated potential for progression. Once the initial signs of maturity become

apparent, the potential for a considerable increase in curvature is

possible. Timely brace treatment is necessary when curves are at 25º – even

sooner when scoliosis reaches 20º prior to the primary growth spurt. Parents

should know that a dramatic increase in curvature can occur in only a few weeks

during a growth spurt.

Although not typical, we have had more than one patient

whose curvature has increased in double digits in less than a month, documented by x-ray, and others who have experienced significant progression within just weeks. Each case is determined individually. However, we generally believe in bracing early when there is the opportunity to do so. This is because we have found a better chance of making a positive impact on a growing spine earlier in the process than later.

The decision of when to brace should be yours as a family—waiting until a curve is 25º or beyond (SRS guidelines), or even in the low 20ºs for younger children,

doesn’t always make sense. We’ve braced many children whose parents have

waited, with regrets, when a growth spurt has resulted in a significant increase in their child’s Cobb angle in only a few months.

To help correct scoliosis or prevent progression, a brace must allow room for corrective movement rather than only applying compression. The Chêneau brace uses a three-dimensional design with corrective voids and lightweight materials. Many patients who did not tolerate other braces have been able to wear this brace successfully.

Unlike most braces, the Chêneau design often aims for overcorrection in patients with flexible, growing spines. Overcorrection moves the curve past the midline toward the opposite direction, which can help stop progression and improve the chance of curve reduction.

It shouldn’t be physically painful to wear a scoliosis brace. If so, brace adjustment may be necessary. A good brace corrects the scoliosis in-brace to the best possible extent without causing pain.