Prospective study and new concepts based on scoliosis detorsion of the first 225 early in-brace radiological results with the new Lyon brace: ARTbrace

Scoliosis

Sophie Pourret²  Frédéric Barral²  Cyril Lecante²  Jean Claude de Mauroy¹ 

[1] Clinique du Parc, Lyon, France;Orten, Lyon, France

关键词: In-brace correction;    Early results;    Cad/Cam;    Moulding;    Torsion;    Concepts;    Lyon brace;    Brace;    Scoliosis;   

Others  :  1145952
DOI  :  10.1186/1748-7161-9-19

 received in 2014-07-13, accepted in 2014-10-17,  发布年份 2014

【 摘 要 】

Background

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 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.

Methods

Instead of a plaster cast, three segmental CAD/CAM moulds are made with the instantaneous full 3D raster stereography digitizer (Orten):

1. In self axial elongation

2. In shift and lumbar lordosis

3. In shift and thoracic kyphosis

A 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.

Results

The 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.

Conclusion

This 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.

【 授权许可】

   
2014 de Mauroy et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 8.

Figure 9.

Figure 10.

Figure 11.

Figure 12.

Figure 13.

Figure 14.

Figure 15.

Figure 16.

Figure 18.

Figure 19.

Figure 20.

Figure 21.

Figure 22.

Figure 23.

Figure 24.

Figure 25.

Figure 26.

Figure 27.

Figure 28.

Figure 29.

【 参考文献 】

• [1]Weinstein SL, Dolan LA, Wright JG, Dobbs MB: Effects of Bracing in Adolescents with Idiopathic Scoliosis. N Engl J Med 2013, 369:1512-1521. October 17, 2013, doi:10.1056/NEJMoa1307337
• [2]Landauer F, Wimmer C, Behensky H: Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up. Pediatr Rehabil 2003, 6(3–4):201-207.
• [3]De Mauroy JC, Lecante C, Barral F: The Lyon approach to the conservative treatment of scoliosis. Scoliosis 2011, 6:4. doi: 10.1186/1748-7161-6-4 BioMed Central Full Text
• [4]Negrini S, Grivas TB, Kotwicki T, Rigo M, Zaina F: Guidelines on “Standards of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research”: SOSORT Consensus 2008. Scoliosis 2009, 4(1):2. BioMed Central Full Text
• [5]Mammano S, Scapinelli R: Plaster casts for the correction of idiopathic scoliosis. Acta Orthop Belg 1992, 58(Suppl 1):81-84.
• [6]de Mauroy JC: Controversial issue session: brace treatment in infantile idiopathic scoliosis: benefits. Scoliosis 2012, 7(Suppl 1):O76. doi:10.1186/1748-7161-7-S1-O76 BioMed Central Full Text
• [7]Mehta MH: Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br 2005, 87-B(9):1237-1247. doi:10.1302/0301-620X.87B9.16124
• [8]Zampini JM, Lewis SHH, Sayre A: The first Professor of Orthopaedic Surgery in America. Clin Orthop Relat Res 2008, 466(9):2263-2267. doi: 10.1007/s11999-008-0349-6
• [9]Cotrel Y, Morel G: The elongation-derotation-flexion technique in the correction of scoliosis. Rev Chir Orthop Reparatrice Appar Mot 1964, 50:59-75. (in French)
• [10]de Mauroy JC, Fender P, Tato B, Lusenti P, Ferracane G: Lyon brace. Stud Health Technol Inform 2008, 135:327-340.
• [11]de Mauroy JC, Lecante C, Barral F, Daureu D, Gualerzi S, Gagliano R: The Lyon brace. Disabil Rehabil Assist Technol 2008, 3(3):139-145. doi:10.1080/17483100801904069
• [12]Sciandra J, de Mauroy JC, Rolet G, Kohler R, Creach JP: Accurate and fast non-contact 3D acquisition of the whole trunk. In Three-dimensional Analysis of Spinal Deformities. Amsterdam, NL, Technology and Informatics 15. Oxford: IOS Press D’Amico M; 1995:81-85.
• [13]De Mauroy JC, David J, Genevois P, Barral F, Lalain JJ: Developing a tool to measure objectively the rib hump from an instantaneous 3D scanning in a full upright position: results of 50 scoliosis before and after plaster cast. Scoliosis 2010, 5(Suppl 1):O13. BioMed Central Full Text
• [14]de Mauroy JC, Barral F, Lecante C: A statistic approach to electronic moulding versus traditional plaster moulding. Scoliosis 2012, 7(Suppl 1):O42. BioMed Central Full Text
• [15]Wong MS, Cheng JC, Lo KH: A comparison of treatment effectiveness between the CAD/CAM method and the manual method for managing adolescent idiopathic scoliosis. Prosthet Orthot Int 2005, 29:105-111.
• [16]Sankar WN, Albrektson J, Lerman L, Tolo VT, Skaggs DL: Scoliosis in-brace curve correction and patient preference of CAD/CAM versus plaster molded TLSOs. J Child Orthop 2007, 1(6):345-349.
• [17]Richards BS, Bernstein RM, D'Amato CR, Thompson GH: Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine (Phila Pa 1976) 2005, 30(18):2068-2075. discussion 2076-7
• [18]Weiss HR, Negrini S, Rigo M, Kotwicki T, Hawes MC, Grivas TB, Maruyama T, Landauer F, SOSORT guideline committee: Indications for conservative management of scoliosis (guidelines). Scoliosis 2006, 1:5. doi:10.1186/1748-7161-1-5 BioMed Central Full Text
• [19]Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O’Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagarsa M, Weiss HR, Zaina F: 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012, 7:3. doi:10.1186/1748-7161-7-3 BioMed Central Full Text
• [20]Gallo D, Wood G, Dallmayer R: Quality control of idiopathic scoliosis treatment in 147 patients while using the RSC brace. JPO J Prosthetics Orthotics 2011, 23(2):69-77. doi:10.1097/JPO.0b013e318217c46e
• [21]Rigo M, Negrini S, Weiss HR, Grivas TB, Maruyama T, Kotwicki T, the members of SOSORT: SOSORT consensus paper on brace action: TLSO biomechanics of correction (investigating the rationale for force vector selection). Scoliosis 2006, 1:11. doi:10.1186/1748-7161-1-11 BioMed Central Full Text
• [22]Ferréol R: Circled Helicoid. http://www.mathcurve.com/surfaces/helicoidcercle/helicoidcercle.shtml webcite
• [23]Cheneau J, Corset-Cheneau: Manuel d'Orthopédie des scolioses suivant la technique originale. Paris: Frison Roche; 1994.
• [24]Fryette's Laws - definition of Fryette's Laws in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia Medical-Dictionary.thefreedictionary.com. Retrieved 2012-08-24
• [25]Griffet J, Thévenot J, Barral F: Presentation of GTB orthoses for hyperlordotic treatment of idiopathic scoliosis. Eur J Pediatr Surg 1998, 8(3):163-167.
• [26]Negrini S, Marchini G, Tessadri F: Brace technology thematic series - the Sforzesco and Sibilla braces, and the SPoRT (Symmetric, Patient oriented, Rigid, Three-dimensional, active) concept. Scoliosis 2011, 6:8. doi:10.1186/1748-7161-6-8 BioMed Central Full Text
• [27]Rigo MD, Villagrasa M, Gallo D: A specific scoliosis classification correlating with brace treatment: description and reliability. Scoliosis 2010, 5:1. doi:10.1186/1748-7161-5-1 BioMed Central Full Text
• [28]Ponseti I: Congenital Clubfoot: Fundamentals of Treatment. Oxford, Oxfordshire: Oxford University Press; 1996.
• [29]Bettany-Saltikov J, CooK T, Rigo M, de Mauroy JC, Romano M, Négrini S, Durmala J, del Campo A, Coillard C, M’Hango A, Biallek M: Physical therapy for adolescents with idiopathic scoliosis. In Physical Therapy Perspectives in the 21st Century – Challenges and Possibilities. Intech; 2012:3-40. 978-953-51-0459-9
• [30]Aspden RM: Review of the functional anatomy of the spinal ligaments and the lumbar erector spinae muscles. Clin Anatomy 1992, 5(5):372-387. doi:10.1002/ca.980050504
• [31]Stagnara P, de Mauroy JC, Dran G, Gonon GP, Costanzo G, Dimnet J, Pasquet A: Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of Kyphosis and Lordosis. Spine 1982, 7:335-342. ISSN: 0362-2436
• [32]Castro FP Jr: Adolescent idiopathic scoliosis, bracing, and the Hueter-Volkmann principle. Spine J 2003, 3(3):180-185. doi:10.1016/S1529-9430(02)00557-0
• [33]Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME: The Boston bracing system for idiopathic scoliosis: follow-up results in 295 patients. Spine (Phila Pa 1976) 1986, 11(8):792-801.
• [34]Grivas TB, Kaspiris A: European braces widely used for conservative scoliosis treatment. Stud Health Technol Inform. 2010, 158:157-166.
• [35]Rigo M, Quera-Salvá G, Puigdevall N, Martínez M: Retrospective results in immature idiopathic scoliotic patients treated with a Chêneau brace. Stud Health Technol Inform 2002, 2002(88):241-245.
• [36]Weiss HR, Werkmann M: "Brace Technology" Thematic Series - The ScoliOlogiC® Chêneau light™ brace in the treatment of scoliosis. Scoliosis 2010, 5:19. doi:10.1186/1748-7161-5-19 BioMed Central Full Text
• [37]Grivas TB, Bountis A, Vrasami A, Bardakos NV: Brace technology thematic series: the dynamic derotation brace. Scoliosis 2010, 5:20. BioMed Central Full Text
• [38]Aulisa AG, Mastantuoni G, Laineri M, Falciglia F, Giordano M, Marzetti E, Guzzanti V: Brace technology thematic series: the progressive action short brace (PASB). Scoliosis 2012, 7:6. doi:10.1186/1748-7161-7-6 BioMed Central Full Text
• [39]Appelgren G, Willner S: End vertebra angle: a roentgenographic method to describe a scoliosis. A follow-up study of idiopathic scoliosis treated with the Boston brace. Spine (Phila Pa 1976) 1990, 15(2):71-74.
• [40]Bullmann V, Halm HF, Lerner T, Lepsien U, Hackenberg L, Liljenqvist U: Prospective evaluation of braces as treatment in idiopathic scoliosis. Z Orthop Ihre Grenzgeb 2004, 142(4):403-409.