Dear Krzysztof, 

Scoliosis January 2011, 6:2,

Effectiveness of Chêneau brace treatment for idiopathic scoliosis: prospective study in 79 patients followed to skeletal maturity

Katarzyna Zaborowska-Sapeta, Ireneusz M Kowalski, Tomasz Kotwicki, Halina Protasiewicz-Fałdowska, Wojciech Kiebzak

Treatment of the idiopathic scoliosis with brace and physiotherapy.

Hundozi-Hysenaj H, Dallku IB, Murtezani A, Rrecaj S

Nigerian Journal of Medicine : Journal of the National Association of Resident Doctors of Nigeria [2009, 18(3):256-259]

Dr. Korbel, 

I would recommend you to refer to the publications of Fabio Zaina, Stefano Negrini, Theodoros Grivas and others that are available on the Researchgate database.

You will find many articles in the online journal of the SOSORT   www.scoliosisjournal.com 

And please have a look at this Cochrane Database Syst Rev. 2015 Jun 18;6:CD006850. doi: 10.1002/14651858.CD006850.pub3.

Braces for idiopathic scoliosis in adolescents.  http://www.ncbi.nlm.nih.gov/pubmed/26086959 

Dear Krysztof,

It is the clinical assessment on signs of neuromuscular tension in the body of growing children ( due to in-congruent growth of the skeletal and the nervous tissue ( neuro-osseous growthrelations; Milan Roth) that will become the most important parameter to understand scoliosis. Whit that clinical assessment and understanding of the role early sitting has in deforming our structure(posture)  the solution I found to treat spinal deformities looks the the most efficient. By repositioning the thoracolumbar joint in its most optimal place (in "Lordosis") and lengthen the canal by applying progressive  extension with the TLI brace the neuromuscular system comes back in its original tracts.

Most braces now are based on static pressure on anatomic resultance of the physiologic processes that come first. Form follows function was the key philosophy in Orthopedics from the start. Getting back to influence these physiologic processes into the right direction is also for the children an understandable approach. You will find it in SOSORT proceedings as we met there. We must be aware that in Anglo-American Medicine the complete clinical assessment of the entire body lost its importance or was sometimes completely abandoned. Tightness of muscles, tendons and also the central cord can be asessed easily, but if you don't do this , you miss a lot of information than cannot be replaced bij X rays or even MRI. But MRI beautifully shows what Roth saw already in 1960 with air as contrast in the spinal canal. Onley the first study on this relationship has to be started yet.

I try to split the processes that occur in the different tissues ( bone, cartilage, discs, tendons and fasciae, synovial joints,  muscles and nerves on the way to deformations like scoliosis. But it can be applied to other 3D deformations as flatfeet, varus-overstretch knees etc. .

Problem is the language, because many of these processes and characteristics do have a German verb, that does not exsist in english or must be replaced by words with different meanings.

I started with an article for the Dutch Physiotherapists, that are about to come back in their original posture correcting knowledge ( that survived like in Schroth) .

It is time for a change, good luck,

Piet

I think the best original article (multicenter study) in this topic is:

Effect of Bracing in Adolescent with Idiopathic Scoliosis from Weinstein SL and all.

in the New England Journal of Medicine November 20 2013.

N Engl J Med. 2013 Oct 17;369(16):1512-21. doi: 10.1056/NEJMoa1307337. Epub 2013 Sep 19.

Effects of bracing in adolescents with idiopathic scoliosis.

Weinstein SL1, Dolan LA, Wright JG, Dobbs MB.

Author information

Abstract

BACKGROUND:

The role of bracing in patients with adolescent idiopathic scoliosis who are at risk for curve progression and eventual surgery is controversial.

METHODS:

We conducted a multicenter study that included patients with typical indications for bracing due to their age, skeletal immaturity, and degree of scoliosis. Both a randomized cohort and a preference cohort were enrolled. Of 242 patients included in the analysis, 116 were randomly assigned to bracing or observation, and 126 chose between bracing and observation. Patients in the bracing group were instructed to wear the brace at least 18 hours per day. The primary outcomes were curve progression to 50 degrees or more (treatment failure) and skeletal maturity without this degree of curve progression (treatment success).

RESULTS:

The trial was stopped early owing to the efficacy of bracing. In an analysis that included both the randomized and preference cohorts, the rate of treatment success was 72% after bracing, as compared with 48% after observation (propensity-score-adjusted odds ratio for treatment success, 1.93; 95% confidence interval [CI], 1.08 to 3.46). In the intention-to-treat analysis, the rate of treatment success was 75% among patients randomly assigned to bracing, as compared with 42% among those randomly assigned to observation (odds ratio, 4.11; 95% CI, 1.85 to 9.16). There was a significant positive association between hours of brace wear and rate of treatment success (P

I thank You all for answers

Chêneau brace for adolescent idiopathic scoliosis: long-term results. Can it prevent surgery?

De Giorgi S, Piazzolla A, Tafuri S, Borracci C, Martucci A, De Giorgi G.

Eur Spine J. 2013 Nov;22 Suppl 6:S815-22

• Braces for idiopathic scoliosis in adolescents" (Negrini S, Minozzi S, Bettany-Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F)

 In many cases of idiopathic scoliosis in children at the State Hospital for Children in Moscow by Prof.Dr.Alexey W.Kapustin betterment was found when Detensor - Therapy was included in the treatment program. ([email protected])

Dear prof Kienlein, Thank You for Your answer.

I suggest downloading info about this topic in SRS web.Our practice has shown good results with TLSO in lumbar moderate Idiopathic curves, in colaborative families.