Description and Reliability of Rigo Classification of Adolescent Idiopathic Scoliosis Associated with Brace Therapy

Junze Chen,Bagen Liao

doi:10.11648/j.ijcems.20190504.11

Abstract

Objectives To develop the Rigo classification system for scoliosis brace design and treatment and to compare the reliability and reproducibility of the Rigo classification system for scoliosis within and across observers related to orthopedic treatment. Methods The imaging data of 136 cases of adolescent idiopathic scoliosis were collected, and a Rigo classification system was established to determine the specific corrective principles and methods needed for the effective design and manufacturing of braces. Three observers, one spine surgeon, one imaging surgeon and one orthopedic brace surgeon, diagnosed and classified 136 AIS patients. The collected data were used to analyze the reliability across different observers and the repeatability within the same observer, and kappa values were calculated to confirm the consistency. Results The kappa value of the classification results of the spine surgeons and radiologists was 0.936, that of the spine surgeons and brace surgeons was 0.901, that of the imaging surgeons and brace surgeons was 0.886, the average repeatability was 90%, and the average Kappa was 0.887. Conclusion The Rigo classification system for scoliosis brace therapy has good practicability and consistency. The reliability of the Rigo classification system is acceptable both within and across observers. The system is suitable for clinical applications.

Highlights

Idiopathic scoliosis is a three-dimensional deformity of the spine and trunk induced by multiple factors
The upper structural curve was not considered because the need to use the ‘D modifier’ in the brace design is closely associated with the presence of an upper rib hump observed during the direct examination of the patient in forward bending
Adolescent idiopathic scoliosis (AIS) [5, 6], or delayed scoliosis, is a disease of abnormal curvature and rotation of the spine in the coronal plane accompanied by vertebral rotation, which creates an arc-like shape in the patient's spine

Summary

Introduction

Idiopathic scoliosis is a three-dimensional deformity of the spine and trunk induced by multiple factors. Idiopathic scoliosis may occur in healthy children when they are growing quickly. Growth and development primarily occur during adolescence, and deformities may occur during this period [1]. There are many classification systems for adolescent idiopathic scoliosis (AIS), such as the Lenke and PUMC classification systems, but these classification systems are mainly used to guide spinal surgery. They are not suitable for AIS patients who need conservative treatment in the early stage, and orthopedic brace treatment is considered as clinical treatment. The Milwaukee brace, Boston brace, Wilmington brace, Cheneau brace and Charleston lateral brace are important types of braces for mild to moderate AIS

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