Remodeling of Trunk and Backshape Deformities in Patients with Scoliosis Using Standardized Asymmetric CAD / CAM Braces | Chapter 13 | Highlights on Medicine and Medical Research Vol. 11

 There are articles in the literature on scoliosis that note changes in spinal curvatures when wearing a brace, but these are more based on x-ray findings rather than clinical outcomes. As a result, it's important to (1) review the literature showing improvements after brace treatment and (2) demonstrate what can be done conservatively with bracing in curvatures greater than 45° Cobb.

(1) A PubMed scan of the literature for (a) scoliosis, (b) scoliosis, (c) scoliosis, (d) scoliosis, (e) scoliosis, (e) scoliosis, (e) scoliosis, (e) scoliosis, (e) scoliosis, (e) scoliosis, (e) (2) In addition, a case series of patients with clinical and radiological curvatures greater than 45 degrees is presented.

Results: A keyword search for (a) "scoliosis," "brace care," and "improvement" yielded 92 articles, while a keyword search for (b) "scoliosis," "orthosis," and "improvement" yielded 79 papers. This paper presents a case series of three patients with curvatures greater than 45 degrees, demonstrating radiological and clinical advancement by using the new Chêneau standard of bracing in conjunction with a dependable CAD library of braces and an experienced team.

Standardization is the solution to the high uncertainty in bracing results. When using well-tested, standardised brace templates from CAD libraries, braces can be standardised. Manually made braces, on the other hand, cannot be standardised, resulting in unpredictable results. Furthermore, braces made with CAD/CAM technologies have the ability to improve baseline efficiency in the future.

Conclusions: Even in patients with curvatures greater than 45 degrees, trunk and backshape can be improved conservatively. Radiologically, even scoliotic deformities exceeding 45° Cobb can benefit from modern bracing concepts. Clinical advances achieved by modern bracing concepts are equivalent to those achieved by surgery. Surgery is not recommended for the majority of scoliosis patients with curvatures greater than 45 degrees, due to the long-term negative effects seen in the literature.

Author (s) Details

Hans-Rudolf Weiss
Schroth Best Practice Academy, Neu-Bamberg, Germany.

Marc Moramarco
Scoliosis 3DC, Baldwin Green Common, Suite 204, Woburn, MA, USA.

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