Three-dimensional Effect of the Boston Brace on the Thoracic Spine and Rib Cage

Labelle, Hubert; Dansereau, J.; Bellefleur, Christian; Poitras, Benoît

doi:10.1097/00007632-199601010-00013

Cited by 96 publications

(58 citation statements)

References 12 publications

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“…To concur with the previous findings of Aubin et al [20] and Labelle et al [21], no statistically significant modification of the transverse plane parameters was noted when considering the mean values. However, a high variability was observed considering all the transverse plane parameters.…”

Section: Discussionsupporting

confidence: 92%

3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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Purpose We have evaluated the effect of bracing in scoliosis on coronal alignment in a cohort of patients. Current literature has not described the specific effect of bracing on the 3D shape of the scoliotic curves. The purpose of this study was to analyze the variability of the 3D effect of bracing on idiopathic scoliosis. Materials and methods The spines of 30 patients with adolescent idiopathic scoliosis were reconstructed using biplanar stereoradiography with and without the brace. The Cobb angle, sagittal and pelvic parameters and transverse plane parameters were calculated. The variability and the mean values of each parameter, with and without a brace, were analyzed and compared using a student t test. Results The Cobb angle improved in 50 % of patients but remained unchanged in 50 % cases. In 90 % of the cases lordosis was decreased. The thoracic kyphosis was decreased in 26 % cases, unchanged in 57 % of cases and increased in 17 % cases. The AVR was improved ([5°) in 26 % cases, worsened in 23 % and unchanged in 50 %. Only the differences of Cobb angle and the lordosis were statistically significant.Conclusions Global statistics of this study concur with the literature. The Cobb angle was significantly improved. It also showed a significant hypolordotic effect. However, the results showed a high variability of the brace treatment effect in almost every parameter. Analysis of this variability by means of 3D reconstructions instead of global statistics should help characterize the mechanisms of correction of brace treatment.

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Section: Discussionsupporting

confidence: 92%

3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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“…Especially for the thoracic curves, the Cobb angles and the translation angles were reduced in the coronal and sagittal plane. Therefore, the brace Our results are confirmed by other studies that have showed that brace treatment had a lordotic effect on the thoracic kyphosis [6,7]. At this time, MR animation is a new procedure with a potential for use in monitoring the brace effect in scoliosis.…”

Section: Discussionsupporting

confidence: 84%

“…The vertical projection allows a simple measurement of the curve magnitude using the Cobb angle method. In comparison with procedures generating three-dimensional spine models, the MR animation provides a direct imaging of the whole scoliotic spine [7,8].…”

Section: Discussionmentioning

confidence: 99%

Visualisation of the brace effect on the spinal profile in idiopathic scoliosis

et al. 2004

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“…At each iteration, scoliotic descriptors were evaluated analytically on the updated spinal configuration. Two regional descriptors were used to characterize the spinal curvatures of the thoracic segment: the Cobb angle in the frontal plane (Cobb) and the kyphosis curvature (k t ) [17]. Three local descriptors were calculated at the thoracic apical vertebra, generally the most deformed vertebra:…”

Section: Simulationsmentioning

confidence: 99%

Biomechanical simulations of the spine deformation process in adolescent idiopathic scoliosis from different pathogenesis hypotheses

Villemure

Aubin

Dansereau

et al. 2004

European Spine Journal

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IntroductionAdolescent idiopathic scoliosis (AIS) is a complex threedimensional (3D) anomaly of the spine involving lateral deviations in the frontal plane, modifications of the sagittal profile, spinal torsion and transverse plane deformations [16,21,23]. There is still no generally accepted scientific theory for its etiology [7,16,21,23]. The pathogenesis of AIS is not clearly defined regarding either how Abstract It is generally recognized that progressive adolescent idiopathic scoliosis (AIS) evolves within a selfsustaining biomechanical process involving asymmetrical growth modulation of vertebrae due to altered spinal load distribution. A biomechanical finite element model of normal thoracic and lumbar spine integrating vertebral growth was used to simulate the progression of spinal deformities over 24 months. Five pathogenesis hypotheses of AIS were represented, using an initial geometrical eccentricity (gravity line imbalance of 3 mm or 2°rotation) at the thoracic apex to trigger the self-sustaining deformation process. For each simulation, regional (thoracic Cobb angle, kyphosis) and local scoliotic descriptors (axial rotation and wedging of the thoracic apical vertebra) were evaluated at each growth cycle. The simulated AIS pathogeneses resulted in the development of different scoliotic deformities. Imbalance of 3 mm in the frontal plane, combined or not with the sagittal plane, resulted in the closest representation of typical scoliotic deformities, with the thoracic Cobb angle progressing up to 39°(26°when a sagittal offset was added). The apical vertebral rotation increased by 7°t owards the convexity of the curve, while the apical wedging increased to 8.5°(7.3°with the sagittal eccentricity) and this deformity evolved towards the vertebral frontal plane. A sole eccentricity in the sagittal plane generated a non-significant frontal plane deformity. Simulations involving an initial rotational shift (2°) in the transverse plane globally produced relatively small and nontypical scoliotic deformations. Overall, the thoracic segment predominantly was sensitive to imbalances in the frontal plane, although unidirectional geometrical eccentricities in different planes produced three-dimensional deformities at the regional and vertebral levels, and their deformities did not cumulate when combined. These results support the hypothesis of a prime lesion involving the precarious balance in the frontal plane, which could concomitantly be associated with a hypokyphotic component. They also suggest that coupling mechanisms are involved in the deformation process.

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Three-dimensional Effect of the Boston Brace on the Thoracic Spine and Rib Cage

Cited by 96 publications

References 12 publications

3D analysis of brace treatment in idiopathic scoliosis

3D analysis of brace treatment in idiopathic scoliosis

Visualisation of the brace effect on the spinal profile in idiopathic scoliosis

Biomechanical simulations of the spine deformation process in adolescent idiopathic scoliosis from different pathogenesis hypotheses

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