Outcome of Conservative Therapy of Adolescent Idiopathic Scoliosis (AIS) with Chêneau-Brace

Abstract

Chêneau-brace (C-Brace) is a potential tool for the treatment of adolescent idiopathic scoliosis (AIS) with a Cobb angle between 20° and 45° for the primary curve. The aim of the present study was (1) to estimate study cohorts with C-brace therapy success and therapy failure and (2) to analyze possible factors that influence the therapy outcome. Seventy-eight patients with AIS were assessed before the initiation of C-brace treatment. Each patient underwent radiography examinations before the brace, in-brace, and at the therapy end. Cobb angle was considered as increased when the value at the end of therapy was increased more than 5° (Δ > 5°), unchanged—when the value was unchanged within ± 5° and decreased- when the value was decreased more than 5° (Δ < −5°). The study cohort was stratified due to curve topography in the thoracic, thoracolumbar, and lumbar scoliosis groups. Global analysis revealed no statistically significant modification of the Cobb angle (Cobb angle pre-brace vs. Cobb angle post-brace: 30.8° ± 8.2 vs. 29.3° ± 15.2, p = 0.26). However, at the end of C-brace therapy, the primary Cobb angle was decreased by more than 5° in 27 patients (35%), unchanged (Δ within the range of ±5°) in 36 patients (46%), and increased more than 5° in 15 patients (19%). Sub-group analysis due to curve topography and skeletal maturity has shown higher rates of brace therapy failure in thoracic curves and in younger patients (Risser grade 0). Patients with higher Cobb angle correction with C-brace had lower rates of therapy failure. The C-brace can be useful for the prevention of scoliotic curve progression in patients with AIS. However, many factors influence the therapy effect.

Comparison of Motor Evoked Potentials Neuromonitoring Following Pre- and Postoperative Transcranial Magnetic Stimulation and Intraoperative Electrical Stimulation in Patients Undergoing Surgical Correction of Idiopathic Scoliosis

“…The conservative treatment by means of physiotherapy [5] and Cheneau-brace [6][7][8] application can be useful for the prevention of scoliotic curve progression and sometimes slows down or limits progression in patients with IS. However, many factors influence the effect of such a therapy, and the surgical implantation of deformity corrective instrumentation is necessary in the majority of progressive IS cases [9], especially when its lateral main angle exceeds 40 degrees [10].…”

The Long-term Effects of Improving the Motor Neural Transmission Verified with Clinical Neurophysiology Methods in Patients with Surgically Treated Idiopathic Scoliosis

“…Secondarily, disorders in the conduction of neural impulses within the spinal roots, development of neuropathy in the peripheral nervous system, and neurogenic changes in the muscular system occur [1,2]. Kinesiotherapeutic treatment [3,4] and bracing [5][6][7][8] for improving the proper body posture, in the majority of IS patients provide only partial benefits for slowing down the progression of the pathological curvature. Negrini et al [9,10] concluded on the necessity for surgical intervention in IS patients with a primary Cobb angle of 40-45 degrees when a fast worsening of the pathology is expected.…”

Clinical Neurophysiological Methods Verify Improvement in the Motor Neural Transmission in Patients with Surgically Treated Idiopathic Scoliosis in Long-Term Follow-up

“…In the majority of IS patients, kinesiotherapeutic treatment [8,9] and bracing [10][11][12][13] for improving their body posture provide only partial benefits for slowing down the progression of the pathological curvature. Negrini et al [14,15] concluded the necessity for surgical intervention in IS patients with a primary Cobb angle of 40-45 degrees, where a fast worsening of the pathology is expected.…”