Effect of Chêneau style braces on vertebral wedging amongst individuals with adolescent idiopathic scoliosis.

BACKGROUND

It is generally accepted that braces can stop curve progression but little evidence exists regarding structural improvement in the spine using spinal bracing. Our study aimed to investigate the possible structural improvements of vertebral wedging with high correction bracing.

OBJECTIVES

The aim of our study was to assess whether spinal brace treatment may influence vertebral wedging in adolescent idiopathic scoliosis (AIS).

METHOD: We reviewed our database according to the following inclusion criteria: girls with a diagnosis of AIS, Risser 0-2, age 10-14 years with Cobb angles greater than 35°. Our study cohort consisted of 27 patients fulfilling the inclusion criteria with an average brace wearing time of 16.6 h per day and Cobb angles between 36° and 79°. The target value for our study was the apical vertebra wedging, measured twice before brace treatment commenced and twice after the average follow-up period of 20.5 months of treatment.

RESULTS

The average apex wedging noted before brace wearing started was 9.8° (median: 9) and after a period of 20.5 months of brace wearing, it had reduced to an average of 5.8° (median: 4.9), (p < 0.001). This would indicate a structural correction of 44%.

CONCLUSIONS

Our study supports the hypothesis that spinal high correction braces improve the degree of vertebral wedging in skeletally immature girls with AIS.

CLINICAL IMPLICATIONS: Structural corrections of the apical vertebra seem possible when high correction asymmetric braces are used in the treatment of patients with AIS.