2- and 3-dimensional correction of scoliosis by corset treatment. Optimized conservative therapy of idiopathic scoliosis with the improved Cheneau corset

Abstract

It is generally accepted that the progression of an idiopathic scoliotic deformity with a Cobb angle of between 25 degrees and 40 degrees can be stopped by brace treatment alone provided that the generally acknowledged criteria for the treatment concerning skeletal growth of the individual are respected. In Europe, the Cheneau brace, which was originally designed as an active derotation orthosis, is widely in use and is constantly being improved. The biomechanical principle of this orthosis consists of a pressure vector that is applied laterally (with regard to the 3-point principle) to exert pressure on the peak of the curvature in the frontal and transversal planes. Thus, the thoracic, lumbar and pelvic body mass that was rotated out of normal body symmetry is transferred back to its original position via pressure and derotation. Therefore, an active back like the Cheneau orthosis must provide pressure surfaces and sufficient expansion spaces. Subtle insights into the actual effect of braces have furthered ongoing development to take into consideration the changes to the trunk in the sagittal plain and have respected the different states of expansion of the two halves of the trunk in the craniocaudal direction. The thoracic flat back and cyphosis of the lumbal spine, which were formerly ignored, actually provide a real challenge for the technical realization of the brace. The new generation of Cheneau braces potentially provides an effective means for the active correction of scoliotic spinal deformity in all three dimensions and thus fulfills the requirements of modern conservative scoliosis treatment.