Abstract
BackgroundBracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type. We compared outcomes of AIS patients treated with Rigo Chêneau orthoses (RCOs) or custom-molded Boston-style thoracolumbosacral orthoses (TLSOs).MethodsWe retrospectively reviewed patient records from one scoliosis center from 1999 through 2014. Patients were studied from initial treatment until skeletal maturity or surgery. Inclusion criteria were a diagnosis of AIS, initial major curve between 25° and 40°, use of an RCO or TLSO, and no previous scoliosis treatment.ResultsThe study included 108 patients (93 girls) with a mean (±standard deviation) age at brace initiation of 12.5 ± 1.3 years. Thirteen patients wore an RCO, and 95 wore a TLSO. Mean pre-bracing major curves were 32.7° ± 4.8° in the RCO group and 31.4° ± 4.4° in the TLSO group (p = 0.387). Mean brace wear time was similar between groups. Mean differences in major curve from baseline to follow-up were −0.4° ± 9.9° in the RCO group and 6.9° ± 12.1° in the TLSO group (p = 0.028). Percent changes in major curve from baseline to follow-up were 0.0% ± 30.5% for the RCO group and 21.3% ± 38.8% for the TLSO group (p = 0.030). No RCO patients and 34% of TLSO patients progressed to spinal surgery (p = 0.019). At follow-up, major curves improved by 6° or more in 31% of the RCO group and 13% of the TLSO group (p = 0.100).ConclusionsPatients treated with RCOs compared with Boston-style TLSOs had similar baseline characteristics and brace wear time yet significantly lower rates of spinal surgery. Patients with RCOs also had lower mean and percent major curve progression versus those with TLSOs.
Highlights
Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type
Ninety-five patients were treated with a thoracolumbosacral orthosis (TLSO), and 13 patients were treated with an Rigo Chêneau orthosis (RCO)
At follow-up, major curves improved by 6° or more in 31% of the RCO group and 13% of the TLSO group (p = 0.100)
Summary
Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type. We compared outcomes of AIS patients treated with Rigo Chêneau orthoses (RCOs) or custom-molded Boston-style thoracolumbosacral orthoses (TLSOs). Since the Bracing in Adolescent Idiopathic Scoliosis Trial study in 2013 [4], bracing has been increasingly recognized as an effective nonsurgical means of scoliosis treatment. The comparative effectiveness of most types of braces for AIS has not been definitively established [5]. Rigo Chêneau orthoses (RCOs) were developed approximately two decades ago, with the intent to combine biomechanical forces in three dimensions, including curve derotation. They use an open pelvis design with anterior opening. Studies of the RCO are limited, and we know little about its effectiveness, in relation to other braces [5, 7, 8]
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