The Effect of Rigo-Cheneau Type Bracing According to Wood-Cheneau-Rigo Concept on Cobb Angle Change in Adolescents with Idiopathic Scoliosis - A Retrospective Chart Analysis
By Grant Wood, MSc, CPO & Sanja Schreiber, PhD, MSc, Schroth Instructor
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Background
In North America (NA), bracing is a standard of care for growing patients with adolescent idiopathic scoliosis (AIS) and curves 20°- 40°. The main goal of the brace treatment is to stop curve progression. Most commonly prescribed are tubular-shaped TLSO braces. Cheneau type braces are designed to reach the best possible 3D correction. One of the most popular Rigo Cheneau type braces in NA is Wood-Cheneau-Rigo (WCR) brace. Research suggests that TLSO bracing prevents scoliosis progression to the threshold for surgery. The evidence of the effectiveness of the Cheneau brace is lacking.
Objective
To determine the effect of at least 1-year WCR intervention on the Cobb angle change in patients with AIS.
Methods
Design: Retrospective chart analysis
Subjects:
- N = 26 adolescents with AIS
- Age: 10 to 16
- Risser score: 0 to 4
- Cobb angle: 15° and 49°
The primary outcome: change in the Largest Curve (LC).
Procedure
- Clinical evaluation and 3D scanning (Rodin Neo Software)
- Computer-aided design/computer-aided manufacturing (CAD/CAM) 3D modeling of a brace positive
- Production of a hand-modified hypercorrected mold
- Each brace was custom-fitted, and the in-brace correction was checked
- Patients were followed-up for at least a year
- Out-of-brace radiographs were taken at baseline and follow-up with a patient being out of a brace for at least 24 hours
- The patients were instructed to wear a brace full time (20-23h/day).
Statistics
- The repeated measures ANCOVA was used to determine the effect of the treatment on change in the LC over time using weight as a covariate.
Results
- Mean age was 12.8±1.5
- Risser score was 1.57±1.5
- LC was 33.5°±9.7°
- 26 patients: 22 were girls.
- Mean follow-up 16.1 ±4.2 months
- LC improved by 10.4°±7.0° (p<0.001) with weight as a covariate
- Weight had a significant main effect (0.37± 0.71), p=0.011) -> for every 1kg increase the patients had on average 0.37 larger LC.
Conclusion
- WCR braces improved the LC by 10.4° on average over a mean follow-up of 16.1 ±4.2 months in immature patients with AIS.
- Heavier patients had consistently larger curves on average during the course of the treatment.
- Further research to establish the long-term effect of the 3D Cheneau type brace concept is warranted.
Works Cited
- Weinstein, S., Dolan, L, et al. Effects of Bracing in Adolescents with Idiopathic Scoliosis. N Engl J Med 2013;369:1512-21. DOI:10.1056/NEJMoal 307337
- Wood G., Rigo M., 2017. Innovations in Spinal Deformities and Postural Disorders: The Principles and Biomechanics of the Rigo Cheneau Type Brace (Chapter 8). Intech (ISBN 978-953-51-3542-5, Print ISBN 978-953-51-3541-8)