Abstract
BackgroundThe symmetrical Lyon brace is a brace, usually used to maintain correction after a plaster cast reduction in the Cotrel’s EDF (Elongation-Derotation-Flexion) frame. The new Lyon brace or ARTbrace is an immediate corrective brace based on some of the principles of the plaster cast which are improved due to advances in CAD/CAM technology. The aim of this paper is to describe concepts of this new brace to be not only a replacement of the plaster cast, but also a definitive brace.MethodsInstead of a plaster cast, three segmental CAD/CAM moulds are made with the instantaneous full 3D raster stereography digitizer (Orten):In self axial elongationIn shift and lumbar lordosisIn shift and thoracic kyphosisA specific software (OrtenShape) makes up the overlay of the three moulds. Mould 1 is used for the pelvis and the shoulders mould 2 for the lumbar segment and mould 3 for the thoracic segment.The mathematical basis of the ARTbrace is the torso column which is a circled helicoid with horizontal circle generator. A torso column is reproduced in the opposite direction of the scoliosis.Like the plaster cast, the ARTbrace is worn for a “total time” of 24 hours 7 days a week without modifying the standard protocol of the Lyon brace reduction.The prospective controlled cohort observational study of the 225 first patients treated since May 2013 is reported below.ResultsThe in-brace immediate reduction is: 0.7, i.e. 40% better with the ARTbrace than with a plaster cast. The correction of flat back is 9° (from 18°.4 to 28°.5 kyphosis Cobb angle). The improved aesthetic appearance is equal for rib hump and ATR.ConclusionThis first paper is an introduction with very short results and does not prejudge the final outcome. The ARTbrace can be used not only to replace the plaster cast, but also as a definitive brace. The new segmental moulding with final detorsion is even more efficient and to this day the ARTbrace is the most effective to reduce the Cobb angle of scoliosis.Electronic supplementary materialThe online version of this article (doi:10.1186/1748-7161-9-19) contains supplementary material, which is available to authorized users.
Highlights
The symmetrical Lyon brace is a brace, usually used to maintain correction after a plaster cast reduction in the Cotrel’s Acronym for Elongation Derotation Flexion (EDF) (Elongation-Derotation-Flexion) frame
The plaster cast has proven its effectiveness [5], there is no consensus on the reduction by plaster cast before bracing, which continues to be used for infantile scoliosis [6,7], but was gradually abandoned for Acronym for Adolescent Idiopathic Scoliosis (AIS)
It is difficult to compare the different braces used around the world, we present the results in the same form as the Rigo System Cheneau (RSC) results [20]
Summary
The symmetrical Lyon brace is a brace, usually used to maintain correction after a plaster cast reduction in the Cotrel’s EDF (Elongation-Derotation-Flexion) frame. The new Lyon brace or ARTbrace is an immediate corrective brace based on some of the principles of the plaster cast which are improved due to advances in CAD/CAM technology. The 14 recommendations constituting the SOSORT Criteria derive largely from the experience of major European centres for scoliosis treatment, like the ‘Centre des Massues’ in Lyon. They are the subject of a consensus [4]. The plaster cast has proven its effectiveness [5], there is no consensus on the reduction by plaster cast before bracing, which continues to be used for infantile scoliosis [6,7], but was gradually abandoned for AIS
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