A new method of MR total spine imaging for showing the brace effect in scoliosis

Schmitz, Alfred; Kandyba, J.; Koenig, Roy; Jaeger, U.; Gieseke, J; Schmitt, O.

doi:10.1007/s007760100025

Cited by 16 publications

(6 citation statements)

References 11 publications

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“…Studies reported that brace wear tends to create a hypokyphotic effect and provide a non-significant correction of vertebral axial rotation [13, 14], as well as having no effect on the orientation of the planes of maximum curvature (PMC), which are defined by the planes passing through the apex and the end vertebrae of a given curve [2, 13, 15]. …”

Section: Introductionmentioning

confidence: 99%

3D correction of AIS in braces designed using CAD/CAM and FEM: a randomized controlled trial

et al. 2017

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BackgroundRecent studies showed that finite element model (FEM) combined to CAD/CAM improves the design of braces for the conservative treatment of adolescent idiopathic scoliosis (AIS), using 2D measurements from in-brace radiographs. We aim to assess the immediate effectiveness on curve correction in all three planes of braces designed using CAD/CAM and numerical simulation compared to braces designed with CAD/CAM only.MethodsSRS standardized criteria for bracing were followed to recruit 48 AIS patients who were randomized into two groups. For both groups, 3D reconstructions of the spine and patient’s torso, respectively built from bi-planar radiographs and surface topography, were obtained and braces were designed using the CAD/CAM approach. For the test group, 3D reconstructions of the spine and patient’s torso were additionally used to generate a personalized FEM to simulate and iteratively improve the brace design with the objective of curve correction maximization in three planes and brace material minimization.ResultsFor the control group (CtrlBraces), average Cobb angle prior to bracing was 29° (thoracic, T) and 25° (lumbar, L) with the planes of maximal curvature (PMC) respectively oriented at 63° and 57° on average with respect to the sagittal plane. Average apical axial rotation prior to bracing was 7° (T) and 9° (L). For the test group (FEMBraces), initial Cobb angles were 33° (T) and 28° (L) with the PMC at 68° (T) and 56° (L) and average apical axial rotation prior to bracing at 9° (T and L). On average, FEMBraces were 50% thinner and had 20% less covering surface than CtrlBraces while reducing T and L curves by 47 and 48%, respectively, compared to 25 and 26% for CtrlBraces. FEMBraces corrected apical axial rotation by 46% compared to 30% for CtrlBraces.ConclusionThe combination of numerical simulation and CAD/CAM approach allowed designing more efficient braces in all three planes, with the advantages of being lighter than standard CAD/CAM braces. Bracing in AIS may be improved in 3D by the use of this simulation platform. This study is ongoing to recruit more cases and to analyze the long-term effect of bracing.Trial registrationClinicalTrials.gov, NCT02285621

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Section: Introductionmentioning

confidence: 99%

3D correction of AIS in braces designed using CAD/CAM and FEM: a randomized controlled trial

et al. 2017

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“…The Chê-neau brace creates pressure on the convexity of the curve, and, on the opposite side, there are wide expansion chambers in the frontal, sagittal and horizontal planes, where the patient has to put his body mass through physiotherapy of deviation from pushes and respiratory kyphotic exercises for at least 1 h every day [6][7][8]. To correct the flat back, commonly associated with scoliosis [9], a gypsotomy on the cast at T8 is performed and a sternal kyphotic push is applied during the preparation of the brace.…”

Section: Introductionmentioning

confidence: 99%

Chêneau brace for adolescent idiopathic scoliosis: long-term results. Can it prevent surgery?

et al. 2013

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Objective The aim of this study was to evaluate the effectiveness of Chêneau brace in the management of idiopathic scoliosis. Methods This is a retrospective observational study according to SOSORT and SRS (Scoliosis Research Society) recommendations involving 48 girls with documented progressive idiopathic scoliosis, treated with Chêneau brace. A statistical analysis was performed with STATA MP11.2 to validate the obtained results. Results No patient needed surgery. The average curve angle measured in Cobb degrees passed from 27°± 6.7°at the beginning (T0), to 7.6°± 7.4°in brace (T1) (72 % of correction), to 8.5°± 8.6°(69 % of correction) at the end of treatment (T2), to 11.0°± 7.4°(59.3 % of correction) at final follow-up (mean 5 years and 5 months) (T3). Conclusion Conservative treatment with Chêneau brace and physiotherapy was effective in our hands for halting scoliosis progression in 100 % of patients.

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“…Although it has been proved that the curve can be improved in the coronal plane by brace treatment, several studies had reported a thoracic hypokyphotic effect of bracing on the sagittal plane [9-11]. The authors postulate that elastic orthotic belt may also cause flattening of the spine since it forcedly keeps the patient in an "over-extension" position.…”

Section: Introductionmentioning

confidence: 99%

The influence of elastic orthotic belt on sagittal profile in adolescent idiopathic thoracic scoliosis: a comparative radiographic study with Milwaukee brace

Jiang

Qiu

Mao

et al. 2010

BMC Musculoskelet Disord

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BackgroundThe effectiveness of bracing on preventing curve progression in coronal plane for mild and moderate adolescent idiopathic scoliosis (AIS) patients has been confirmed by previous radiographic researches. However, a hypokyphotic effect on the sagittal plane has been reported by a few studies. A relatively increasing number of AIS patients were noticed to wear a new kind of elastic orthotic belt for the treatments of scoliosis without doctors' instructions. We postulate the correcting mechanism of this new appliance may cause flattening of the spine. To our knowledge, no study has investigated the effects of this new orthosis on the sagittal profile of AIS patients. The aim of this study was to evaluate and compare the effects of elastic orthotic belt and Milwaukee brace on the sagittal alignment in AIS patients.MethodsTwenty-eight female AIS patients with mild or moderate thoracic curves were included in this study. Standing full-length lateral radiographs were obtained in three conditions: natural standing posture without any treatment, with elastic orthotic belt and with Milwaukee brace. Thoracic kyphosis (TK), lumber lordosis (LL) and pelvic incidence (PI) were measured and compared between the above three conditions.ResultsBoth elastic orthotic belt and Milwaukee brace can lead to significant decrease of TK, however, the decrease of TK after wearing elastic orthotic belt is significantly larger than that after wearing Milwaukee brace. Compared with no treatment, LL was found to be significantly smaller after wearing Milwaukee brace, however, such significant decrease was not noted after wearing elastic orthotic belt. No significant changes were observed for the PI between 3 conditions.ConclusionsThe elastic orthotic belt could lead to more severe thoracic hypokyphosis when compared with Milwaukee brace. This belt may not be a suitable conservative method for the treatment of mild and moderate AIS patients.

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A new method of MR total spine imaging for showing the brace effect in scoliosis

Cited by 16 publications

References 11 publications

3D correction of AIS in braces designed using CAD/CAM and FEM: a randomized controlled trial

3D correction of AIS in braces designed using CAD/CAM and FEM: a randomized controlled trial

Chêneau brace for adolescent idiopathic scoliosis: long-term results. Can it prevent surgery?

The influence of elastic orthotic belt on sagittal profile in adolescent idiopathic thoracic scoliosis: a comparative radiographic study with Milwaukee brace

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