Impact of Gensingen brace treatment on Lenke 5 curvatures and chronic low back pain in late adolescent and adult scoliosis patients.

Abstract

BackgroundLenke 5C (lumbar and or thoracolumbar) curve patterns lead to loss of lumbar lordosis which is associated with low back pain in later adulthood. We undertook our study to investigate if brace treatment may have an effect on low back pain and on improving the cosmetic appearance in late adolescents and adults.ObjectivesTo estimate if conservative treatment may have an effect on pain in single lumbar curvatures in late adolescent and adult patients with Adolescent Idiopathic Scoliosis (AIS) using a Gensingen Brace by Weiss (GBW).MethodWe investigated AIS patients with Lenke 5C pattern who wore a GBW prospectively. The inclusion criteria of our study were age over 15 years, Cobb angle greater than 20° before treatment and Risser 4 or 5. A verbal pain rating scale was used (no pain, mild pain, moderate pain, severe pain, very severe pain).ResultsA total of 26 patients met the inclusion criteria. The average age was 17.7 years and the average Cobb angle was 41.5°. Nineteen patients (73.1%) experienced mild or moderate chronic low back pain before treatment and seven patients (26.9%) were asymptomatic but seeking treatment for cosmetic reasons. At follow-up, a 23% correction of the curve was achieved. All previously symptomatic patients reported that they no longer experienced low back pain after having worn the brace regularly.ConclusionHigh correction bracing seems to have a positive effect on the curve and on chronic low back pain in patients with a scoliosis and a Lenke 5C curve pattern.Clinical implicationsHigh correction, pattern specific bracing with a GBW may be applied aiming at reducing structural curves and chronic low back pain in late adolescent and adult patients with AIS and with a single lumbar curvature.