Braces for Idiopathic Scoliosis in Adolescents

Négrini, Stefano; Bettany‐Saltikov, Josette; Chockalingam, Nachiappan; Grivas, Theodoros B; Kotwicki, Tomasz; Maruyama, Toru; Romano, Michele; Zaina, Fabio

doi:10.1097/brs.0000000000001887

Cited by 78 publications

(46 citation statements)

References 70 publications

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“…Treatment of AIS with a rigid brace, the most common nonoperative treatment for the prevention of curvature progression, is indicated for a defined group of patients based on their age, sex, magnitude of the curve, and pubertal status. 6,12,17,18 The Chêneau brace, which is intended to de-rotate the apical segment of the curve and provide a 3D correction of the spinal deformity, 19 is the most widely used rigid thoracolumbosacral orthosis in Europe.2 The major mechanism of this orthosis is 3D correction of the spinal deformity through a system of multipoint pressure zones and expansion chambers.2,10 The Chêneau brace creates pressure on the convexity of a curve, and on the opposite side are wide expansion chambers in the frontal, sagittal, and horizontal planes. 9 Regarding the outcomes of brace application, the Chêneau brace has been found to prevent curve progression and to decrease axial rotation.…”

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Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Fang¹,

Wang²,

Xiang³

et al. 2015

SPI

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OBJECT The aim of the present study was to retrospectively evaluate progressive correction of coronal and sagittal alignment and pelvic parameters in patients treated with a Chêneau brace. METHODS Thirty-two patients with adolescent idiopathic scoliosis (AIS) were assessed before initiation of bracing treatment and at the final follow-up. Each patient underwent radiological examinations, and coronal, sagittal, and pelvic parameters were measured. RESULTS No statistically significant modification of the Cobb angle was noted. The pelvic incidence remained unchanged in 59% of the cases and increased in 28% of the cases. The sacral slope decreased in 34% of the cases but remained unchanged in 50%. Thoracic kyphosis and lumbar lordosis were significantly decreased, whereas the sagittal vertical axis was significantly increased from a mean of -44.0 to -30.2 mm (p = 0.02). The mean pelvic tilt increased significantly from 4.5° to 8.3° (p = 0.002). CONCLUSIONS The Chêneau brace can be useful for preventing curvature progression in patients with AIS. However, the results of this study reveal high variability in the effect of brace treatment on sagittal and pelvic alignment. Treatment with the Chêneau brace may also influence sagittal global balance.

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confidence: 99%

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confidence: 99%

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Fang¹,

Wang²,

Xiang³

et al. 2015

SPI

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“…The extensive practice in the last six decades on bracing for scoliosis did not lead to wide consensus in approach and method [1,2]. And the results showed poor in terms of correction.…”

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The Development of TLI (Thoracolumbar Lordotic Intervention) as an Effective Bracing Concept for the Postural Spinal Problems - A Review

Erve¹

2015

J Spine

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Introduction: Gaps in knowledge in biomechanics on how the human spine develops itself to the adult posture still exist. It is clear that the huge increase in spinal problems do lack a sound etiologic base, on which effective preventive, conservative and surgical measurements should be based. An innovative technique to correct scoliosis and kyphosis in a non-surgical way is found in the TLI (thoracolumbar lordotic intervention) brace that is based on reversing of the external etiologic factors.

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“…The challenge of orthotic treatment is to stop or slow down the progression of the spinal curvature prior to skeletal maturity, in order to avoid surgery. Orthotic treatments are widely used for progressive curves; their effectiveness have often been questioned [3,4], but a recent by Weinstein et al [5] showed that bracing could significantly reduce scoliosis progression, especially in those patients with high level of compliance to brace wear.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Patient-Specific Finite-Element Model to Simulate Conservative Treatment in Adolescent Idiopathic Scoliosis

et al. 2015

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Study design: Retrospective validation studyObjectives: To propose a method to evaluate, from a clinical standpoint, the ability of a finite element model (FEM) of the trunk to simulate orthotic correction of spinal deformity, and to apply it to validate a previously described FEM Summary of background data: Several FEMs of the scoliotic spine have been described in the literature. These models can prove useful in understanding the mechanisms of scoliosis progression and in optimizing its treatment, but their validation has often been lacking or incomplete.Methods: Three-dimensional geometries of ten patients before and during conservative treatment were reconstructed from bi-planar radiographs. The effect of bracing was simulated by modeling displacements induced by the brace pads. Simulated clinical indices (Cobb angle, T1-T12 and T4-T12 kyphosis, L1-L5 lordosis, apical vertebral rotation, torsion, rib hump) and vertebral orientations and positions were compared to those measured in the patients' three-dimensional geometries.Results: Errors in clinical indices were of the same order of magnitude as the uncertainties due to 3D reconstruction; for instance, Cobb angle was simulated with a root mean square error of 5.7° and rib hump error was 6.4°. Vertebral orientation was simulated with a root mean square error of 4.8° and vertebral position with an error of 2.5 mm. Conclusions:The methodology proposed here allowed in-depth evaluation of subject-specific simulations, confirming that FEMs of the trunk have the potential to accurately simulate brace action. These promising results provide a basis for ongoing 3D model development, toward the design of more efficient orthoses.

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Braces for Idiopathic Scoliosis in Adolescents

Abstract: A Cochrane Systematic Review OBJECTIVE.: To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological and cosmetic issues

Cited by 78 publications

References 70 publications

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

The Development of TLI (Thoracolumbar Lordotic Intervention) as an Effective Bracing Concept for the Postural Spinal Problems - A Review

Evaluation of a Patient-Specific Finite-Element Model to Simulate Conservative Treatment in Adolescent Idiopathic Scoliosis

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