The Lyon Brace

Mauroy, Jean Claude de; Lecante, Cyril; Barral, F.; Daureu, Denis; Gualerzi, Stefano; Gagliano, Rosario

doi:10.1080/17483100801904069

Cited by 22 publications

(23 citation statements)

References 4 publications

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“…Casts have been included here as well. Casts are used by some schools as the first stage to achieve correction to be maintained afterwards with rigid brace [ 106 - 108 ]; others propose casting only in worst cases [ 92 , 93 , 109 , 110 ]; a cast is considered a standard approach in infantile scoliosis [ 111 ]. Recently, a new brace has been developed that has been claimed to achieve same results as casting [ 77 , 112 , 113 ].…”

Section: Evidence-based Clinical Practice Approach To Idiopathic Scolmentioning

confidence: 99%

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

et al. 2012

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BackgroundThe International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS).MethodsAll types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting.ResultsThe contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D.ConclusionThese Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.

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Section: Evidence-based Clinical Practice Approach To Idiopathic Scolmentioning

confidence: 99%

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

et al. 2012

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“…- Compliance, not defiance, is promoted through an evolution in the exercises which are repeated for a few minutes a day at home [7,8]. …”

Section: Contraindications To Brace Wearmentioning

confidence: 99%

"Brace Technology" Thematic Series - The Lyon approach to the conservative treatment of scoliosis

Mauroy¹,

Lecante

Barral

2011

Scoliosis

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The Lyon Brace, or adjustable multi-shell brace, has been used for more than 60 years.The use and function of the Lyon Brace includes:- The utilization of one or two corrective plaster casts, which enables a true lengthening of the concave ligaments.- An oriented CAD-CAM moulding in 3D auto correction after the removal of the plaster cast.- A blueprint adapted to Lenke's classification.- A specific physiotherapy program.BackgroundPierre Stagnara created the Lyon Brace in 1947. The brace has the following characteristics:- It adjusts to allow for a child's growth of up to seven centimetres and for an increase in weight of up to seven kilograms.- It is 'active' in that the rigidity of the PMM (polymetacrylate of methyl) structure stimulates the user to auto-correct. The active axial auto-correction decreases the pressures of the brace on the trunk.- It is decompressive in that the effect of extension between the two pelvic and scapular girdles decreases the pressure on the intervertebral disc allowing for more effective pushes in the other planes.- It is symmetrical making it both more aesthetically pleasing and easier to build.- It is stable at both shoulders and pelvic girdle, facilitating the intermediate 3D corrections.- It is transparent. The pressure of the shells on the skin can be directly controlled so "pads" are usually not necessary.Brace descriptionTwo metal bars are fixed vertically, one anterior the other posterior and all shells are attached from the bottom to the top in this order:- Two pelvic shells ensure an optimal stability of the brace.- One lumbar shell T12-L4, which can be either independent or extending, at the abdominal chondrocostal level.- One thoracic shell at the level of the thoracic convexity.- One opposite thoracic shell used as a counter push.- One shoulder balance shell on the side of the thoracic convexity.Long term follow up resultsThis is a retrospective study of 1,338 completed treatments checked a minimum of two years after weaning from the brace.Only 5% of the curves progressed more than 5° from the initial magnitudes. This translates to an effectiveness index of 0.95.A subset of 174 subjects who started treatment at Risser 0 was isolated. The global progressive angular mean curve was superimposed on the statistic general curve and the effectiveness index was calculated at 0.80.The Surgery rate was just 2% of the patients presenting with an initial curve below 45°.ConclusionThe Lyon Brace is the historical reference of bracing AIS. To be fully effective, it requires the patient to wear a plaster cast for at least one month and receive specific physiotherapy training. Although this is a retrospective study, the results are very positive, and clearly indicate a need for a prospective study.

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“…Our hypothesis is that complete muscle relaxation, allows the surgeon to better derotate the spine while straightening it. Both rib vertebral angle difference and apical vertebral degree improved [17,[19][20][21][22][23][24]. Canavese et al showed that rib vertebral angle difference and apical vertebral degree are expression of vertebral rotation and can be used to better characterize the spinal deformity and/or to evaluate effects of brace or surgical treatment [24].…”

Section: Discussionmentioning

confidence: 99%

“…Both rib vertebral angle difference and apical vertebral degree improved [17,[19][20][21][22][23][24]. Canavese et al showed that rib vertebral angle difference and apical vertebral degree are expression of vertebral rotation and can be used to better characterize the spinal deformity and/or to evaluate effects of brace or surgical treatment [24]. However, the rib vertebral angle difference was originally described for children under the age of 2 years and its value for JS is not yet known [13,24].…”

Section: Discussionmentioning

confidence: 99%

Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results

Canavese¹,

Botnari²,

Diméglio

et al. 2015

Eur Spine J

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The Lyon Brace

Cited by 22 publications

References 4 publications

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

"Brace Technology" Thematic Series - The Lyon approach to the conservative treatment of scoliosis

Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results

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