Follow-up of an Elongation Bending Derotation Brace in the treatment of infantile scoliosis.

Abstract

Since 2013, an elongation bending derotation brace (EBDB) has been developed and applied to EOS in our institution. The goals of the study were: 1) to compare radiographic changes before the use of EBDB (Pre-B), in brace (IB), and after the use of EBDB (Post-B) in a minimal two year follow-up; 2) to determine the compliance with the EBDB. Thirteen children diagnosed with an infantile scoliosis (IS) were retrospectively recruited. Under general anesthesia in the OR, child was placed on a Spica casting table, and the spine was manipulated by stockinet straps. Then 3D child's torso was scanned, the EBDB was designed and manufactured for exact fitting to the torso in the corrected position using CAD/CAM technology.1 Mean age at start of EBDB was 2 years and 6 months. Average follow-up was 36 months. Compliance showed a mean 19 hours per day (14 to 23 hours). Pre-treatment Cobb angle was 40°, in brace 22°, and out of brace 28°(p<0.05). Axial vertebral rotation (AVR) by Nash-Moe method improved from 30% before treatment to 21% in brace and 19% at the end of visit (p<0.05). Kyphosis was significantly increased from 16°(Pre-B) to 32°(Post-B) (P<0.05). However, there was reduction of Rib-vertebral angle difference (RVAD) from 23°(Pre-B) to 11°(Post-B) (P>0.05). A cascade of EBDB effectively corrects and stabilizes the 3D spinal deformities in infantile. Thus the EBDB is considered as a successful modality in the treatment of IS children.