"Brace technology" thematic series - the Gensingen brace™ in the treatment of scoliosis

BackgroundBracing concepts in use today for the treatment of scoliosis include symmetric and asymmetric hard braces usually made of polyethylene (PE) and soft braces. A new asymmetric Chêneau style CAD/CAM derivate has been designed to overcome problems the author experienced with other Chêneau CAD/CAM systems over the recent years.Brace descriptionThis CAD/CAM Chêneau derivate has been called Gensingen brace™, a brace available to address all possible curve patterns. Once the patients' trunk is scanned with the help of a whole trunk optical 3D-scan and the patients' data from the clinical measurements are recorded, a model of the brace can be created by (1) modifying the trunk model of the patient 'on screen' to achieve a very individual brace model using the CAD/CAM tools provided or by (2) choosing a brace model from our library and re-size it to the patients' properties 'on screen'.ResultsEnd-result studies have been published on the Chêneau brace as early as 1985. Cohort studies on the Chêneau brace are available as is a prospective controlled study respecting the SRS criteria for bracing studies, demonstrating beneficial outcomes, when compared to the controls using a soft brace. Sufficient in-brace correction effects have been demonstrated to be achievable when the Chêneau principles of correction are used appropriately. As there is a positive correlation between in-brace correction and the final outcome, the Chêneau concept of bracing with sufficient in-brace corrections as published can be regarded as being efficient when applied well. Case reports with high in-brace corrections, as shown within this paper using the Gensingen brace™ promise beneficial outcomes when a good compliance can be achieved.ConclusionsThe use of the Gensingen brace™ leads to sufficient in-brace corrections, when compared to the correction effects achieved with other braces, as described in literature.According to the patients' reports, the Gensingen brace™ is comfortable to wear, when adjusted properly.Further studies are necessary (1) in order to evaluate brace comfort and (2) effectiveness using the SRS inclusion criteria.

[1]  J. Heine,et al.  Endergebnisse der konservativen Behandlung der Skoliose mit dem Milwaukee-Korsett , 1985 .

[2]  R. Betz,et al.  Adolescent Idiopathic Scoliosis: A New Classification to Determine Extent of Spinal Arthrodesis , 2001, The Journal of bone and joint surgery. American volume.

[3]  E. Fogarty,et al.  Adolescent Idiopathic Scoliosis: The Effect of Brace Treatment on the Incidence of Surgery , 2001, Spine.

[4]  J. Heine,et al.  [Proceedings: Results of conservative treatment of scoliosis with the Milwaukee brace]. , 1974, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[5]  R. Winter,et al.  The selection of fusion levels in thoracic idiopathic scoliosis. , 1983, The Journal of bone and joint surgery. American volume.

[6]  M. Rigo AbstractsInternational conference on conservative management of spinal deformities Barcelona 23–24 January 2004 , 2004 .

[7]  A. Kaelin,et al.  The Boston Bracing System for Idiopathic Scoliosis: Follow-up Results in 295 Patients , 1986, Spine.

[8]  S. Willner,et al.  End Vertebra Angle—A Roentgenographic Method to Describe a Scoliosis: A Follow-up Study of Idiopathic Scoliosis Treated with the Boston Brace , 1990, Spine.

[9]  M. Rigo Radiological and cosmetic improvement 2 years after brace weaning—a case report , 2003, Pediatric rehabilitation.

[10]  A. Szulc,et al.  Estimation of the stress related to conservative scoliosis therapy: an analysis based on BSSQ questionnaires , 2007, Scoliosis.

[11]  H. Weiss,et al.  Brace treatment during pubertal growth spurt in girls with idiopathic scoliosis (IS): A prospective trial comparing two different concepts , 2005, Pediatric rehabilitation.

[12]  J. Heine,et al.  [Long-term results of the conservative treatment of scoliosis using the Chêneau brace]. , 1985, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[13]  M. Rigo,et al.  Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis , 2003, Pediatric rehabilitation.

[14]  H. Weiss,et al.  Incidence of surgery in conservatively treated patients with scoliosis , 2003, Pediatric rehabilitation.

[15]  D. Little,et al.  Best practice , 2012, Nature.

[16]  Stefano Negrini,et al.  Indications for conservative management of scoliosis (guidelines) , 2006, Scoliosis.

[17]  H. Weiss,et al.  Befundgerechte Physiotherapie bei Skoliose , 2011 .

[18]  H. Stähelin Guidelines , 1994, Communicating Science.

[19]  H. Noordeen,et al.  Adolescent idiopathic scoliosis , 1991, The Lancet.

[20]  H. Weiss,et al.  Correction effects of the ScoliOlogiC® „Chêneau light" brace in patients with scoliosis , 2007, Scoliosis.

[21]  T. Lerner,et al.  Prospektive Untersuchung zur Korsettbehandlung bei idiopathischen Skoliosen , 2004 .

[22]  Hans-Rudolf Weiss,et al.  The Chêneau concept of bracing--biomechanical aspects. , 2008, Studies in health technology and informatics.

[23]  H. Halm,et al.  [Prospective evaluation of braces as treatment in idiopathic scoliosis]. , 2004, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[24]  J. Heine,et al.  Langzeitergebnisse der konservativen Behandlung der Skoliose mit dem Chêneau-Korsett , 1985 .

[25]  J. Cheng,et al.  A comparison of treatment effectiveness between the CAD/CAM method and the manual method for managing adolescent idiopathic scoliosis , 2005, Prosthetics and orthotics international.

[26]  H. Weiss " Best Practice " in Conservative Scoliosis Care , 2012 .

[27]  M. Rigo,et al.  A specific scoliosis classification correlating with brace treatment: description and reliability , 2009, Scoliosis.

[28]  K Zielke,et al.  [Prognosis of idiopathic scoliosis]. , 1978, Fortschritte der Medizin.

[29]  Neil Roberts,et al.  Research into Spinal Deformities 9 , 2021, Studies in Health Technology and Informatics.

[30]  C. Wimmer,et al.  Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up , 2003, Pediatric rehabilitation.

[31]  F. Castro,et al.  Adolescent idiopathic scoliosis, bracing, and the Hueter-Volkmann principle. , 2003, The spine journal : official journal of the North American Spine Society.

[32]  J. Heine,et al.  [Final results of the conservative treatment of scoliosis using the Milwaukee brace]. , 1985, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[33]  P. Knott Title: a Specific Scoliosis Classification Correlating with Brace Treatment: Description and Reliability , 2022 .