First, the indications, limitations, and contra-indications are not universally established. However, the statement about the effectiveness of bracing is too general, which raises questions regarding the relevance of such a statement for each individual patient. Corroborating the results of previous prospective observational studies, this study showed a strong brace dose-response relationship, with increased benefits from longer hours of brace wear. However, a recent multicenter study about the effects of bracing on adolescents with idiopathic scoliosis, enrolling both a randomized cohort and a preference cohort, concluded that bracing significantly decreased the progression of high-risk curves to the threshold requiring surgery.
concluded that, although the quality of the evidence is limited due to the low methodological quality of the studies, “the available data suggest that, compared with observation, bracing is more potent in preventing the progression of scoliosis and may not have a negative impact on patients’ quality of life.” A previous Cochrane systematic review had showed low-quality evidence in favor of using braces. In a systematic review of the effectiveness of bracing treatment, Maruyama et al. The effectiveness of bracing in the treatment of adolescent idiopathic scoliosis is no longer a controversial issue. This paper, which is about the author’s custom-made version of the popular Chêneau brace, follows the format for the “ Scoliosis brace thematic series.” This present version is also supported by scientific results from several independent teams. Conclusionsĭifferent independent teams have published comparable outcomes by using Chêneau-type braces and versions in combination with specific exercises and following a similar scoliosis comprehensive care model. Resultsīlueprints for construction of the brace according to the revisited Rigo classification are fully described in this paper. The brace is open in front and can be considered rigid and dynamic at the same time. Expansion areas are also essential for tissue migration, growth, and breathing movements, although body reactions depend basically on how well designed are the contact areas. A custom-made TLS brace (thoracolumbosacral) is built in order to provide highly defined contact areas, which are located, shaped, and oriented in the space to generate the necessary vectors of force to correct in 3D. This current authors’ version has been named “3D Rigo Chêneau-type brace.” The 3D principles are related to a detorsional mechanism created by forces and counterforces to bring the trunk into the best possible correction: (1) three-point system (2) regional derotation (3) sagittal alignment and balance. The classification also correlates with specific exercises (PSSE) according to the Barcelona School, using Schroth principles (BSPTS). The contribution of the present authors is about to the description of the principles based on biomechanics and a specific classification created to help to standardize the brace design and construction.
This paper follows the format of the “Brace technology thematic series.” The Chêneau-type brace has been versioned by many authors. Principles to construct this brace were originally based on anatomical descriptions rather than biomechanics, and its standard is poor. The name “CTM” is still popular in France but “Chêneau-type brace” is its common name in the rest of the world. The brace was initially named “CTM” from Chêneau-Toulouse-Münster. Chêneau and Matthias introduced in 1979 a brace concept inspired in casting.