Rate of surgery in patients treated with a Chêneau light brace using the SRS inclusion criteria
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Orthopedic Rehabilitation Services, Germany
Orthomed Scolicare, Orthopedic Technical Services, Germany
Submission date: 2011-08-03
Acceptance date: 2011-11-09
Publication date: 2020-04-10
Corresponding author
Hans-Rudolf Weiss   

Orthopedic Rehabilitation Services, Alzeyer Street 23, D-55457 Gensingen, Germany. Tel.: +49 6727 894040; fax: +49 6727 8940429.
Pol. Ann. Med. 2012;19(1):1-8
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. Prospective cohort studies are available using the Scoliosis Research Society (SRS) inclusion criteria for studies on bracing. These seem to provide a great advantage in comparing different strategies of bracing against each other. Because we had gathered all data pertaining to patients treated with a Chêneau light brace between June 2005 and November 2007, it was possible to identify that sample of patients fulfilling the SRS inclusion criteria from the entire sample.

The aim of this study was to investigate treatment outcomes in patients treated with Chêneau light brace, who met the SRS inclusion criteria for studies on bracing.

Material and methods:
In total, 34 patients (of 152) fulfilled the SRS inclusion criteria having an average age of 12.06 years (10–13 years), an average Cobb angle of 31° (25–40°), an average Risser stage of 0.35, an average in-brace Cobb angle of 13° (i.e., 59% of in-brace correction). There were 17 thoracic, 10 double major, 6 lumbar and 2 thoracolumbar curve patterns. After a change of workplace concerning the first author, patients could not be followed up on as originally planned. Therefore, telephone interviews were performed by the second author.

In total, 28 patients (average age of 16.5 years) have been contacted, 9 of them still undergoing their treatment. No patient has been operated on (rate of surgery is 0%) and only 1 was not satisfied with the cosmetic outcome of the treatment.

The rate of surgery was far less than reported in recent studies using the same inclusion criteria even when all drop outs were rated as failures.

The rate of surgery can be reduced with the help of Chêneau braces of the latest standard and satisfactory in-brace correction. Brace treatment employing the Chêneau brace seems to be effective and, therefore, is clearly recommended. Clinical outcomes may be more important for a patient than radiological outcomes.

The content of this paper was first presented at the 8th Annual Meeting of the SOSORT, May 2011 in Barcelona. The authors are grateful to Scoliocare Orthomed, Orthopedic Technical Services, Gensingen, Germany, for their kind support. The authors wish to thank Lesley Schneider for copyediting this paper. Written informed consents were obtained from all persons visible on the pictures submitted.
The first author is applying for a patent relating to the content of this paper and is advisor of Koob-Scolitech, Abtweiler, Germany. Mario Werkmann declares to have no competitive interest.
Appelgren G, Willner S. End vertebra angle – a roentgenographic method to describe a scoliosis. A follow-up study of idiopathic scoliosis treated with the Boston brace. Spine. 1990;15(2):71–74.
Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2.
Castro Jr FP. Adolescent idiopathic scoliosis, bracing, and the Hueter – Volkmann principle. Spine J. 2003;3(3):180–185.
Coillard C, Vachon V, Circo AB, Beauséjour M, Rivard CH. Effectiveness of the SpineCor brace based on the new standardized criteria proposed by the Scoliosis Research Society for adolescent idiopathic scoliosis. J Pediatr Orthop. 2007;27(4):375–379.
Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity. Spine. 2007;32(20):2198–2207.
Dolan LA, Weinstein SL. Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review. Spine. 2007;32(19):91–100.
Edelmann P. Brace treatment in idiopathic scoliosis. Acta Orthop Belg. 1992;58(1):85–90.
Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME. The Boston bracing system for idiopathic scoliosis: follow-up results in 295 patients. Spine. 1986;11(8):792–801.
Goldberg CJ, Moore DP, Fogarty EE, Dowling FE. Adolescent idiopatic scoliosis: the effect of brace treatment on incidence of surgery. Spine. 2001;26(1):42–47.
Hawes MC. Impact of spine surgery on signs and symptoms of spinal deformity. Pediatr Rehabil. 2006;9(4):318–339.
Hawes MC, O’Brien JP. A century of spine surgery: what can patients expect?. Disabil Rehabil. 2008;30(10):808–817.
Hopf C, Heine J. Long-term results of the conservative treatment of scoliosis using the Chêneau brace. Z Orthop Ihre Grenzgeb. 1985;123(3):312–322 [in German].
Landauer F, Wimmer C, Behensky H. Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up. Pediatr Rehabil. 2003;6(3–4):201–207.
Maruyama T, Grivas TB, Kaspiris A. Effectiveness and outcomes of brace treatment: a systematic review. Physiother Theory Pract. 2011;27(1):26–42.
Maruyama T, Kitagawa T, Takeshita K, Mochizuki K, Nakamura K. Conservative treatment for adolescent idiopathic scoliosis: can it reduce the incidence of surgical treatment?. Pediatr Rehabil. 2003;6(3–4):215–219.
Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am. 1995;77(6):815–822.
Rigo M. 3D correction of trunk deformity in patients with idiopathic scoliosis using Chêneau Brace. In: Stokes IA, Dangerfield P, eds. Research Into Spinal Deformities. Vol. 2 Amsterdam: IOS Press; 1999: 362–365.
Rigo M. Radiological and cosmetic improvement 2 years after brace weaning: a case report. Pediatr Rehabil. 2003;6(3–4):195–199.
Rigo M, Reiter C, Weiss H-R. Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil. 2003;6(3–4):209–214.
Rigo M, Weiss H-R. Korsettversorgungsstrategien in der Skoliosebehandlung. In: Weiss H-R, ed. Wirbelsäulendeformitäten: Konservatives Management. Munich: Pflaum; 2003 [in German].
Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D. A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis. J Bone Joint Surg Am. 1997;79(5):664–674.
Thompson GH, Richards Iii BS. Inclusion and assessment criteria for conservative scoliosis treatment. Stud Health Technol Inform. 2008;135:157–163.
Weiss H-R. Adolescent idiopathic scoliosis (AIS): an indication for surgery? A systematic review of the literature. Disabil Rehabil. 2008;30(10):799–807.
Weiss H-R. Anpassungsanleitung für die ‘‘Chêneau light’’ Orthese. Munich: Pflaum. 2006 [in German].
Weiss H-R. ‘‘Best Practice’’ in conservative scoliosis care. Munich: Pflaum; 2010.
Weiss H-R. Brace technology thematic series: the Gensingen braceTM in the treatment of scoliosis. Scoliosis. 2010;5:22.
Weiss H-R. Clinical improvement and radiological progression in a girl with early onset scoliosis (EOS) treated conservatively – a case report. Scoliosis. 2006;26(1):13.
Weiss H-R. Debate on: bracing in adolescent scoliosis trial (BrAIST) – will the expenditure pay?. Scoliosis. 2009;4(suppl 2):O43.
Weiss H-R. Ein neuer Ansatz zur Konstruktion korrigierender Skolioseorthesen – Das Baukastenprinzip. Med Orth Tech. 2005;128:71–82 [in German].
Weiss H-R, Goodall D. Rate of complications in scoliosis surgery: a systematic review of the PubMed literature. Scoliosis. 2008;5(3):9.
Weiss H-R, Goodall D. The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence: a systematic review. Eur J Phys Rehabil Med. 2008;44(2):177–193.
Weiss H-R, El Obeidi N, Botens-Helmus C. Qualitätskontrolle korrigierender Rumpforthesen in der Skoliosebehandlung. Med Orth Tech. 2003;126:39–46 [in German].
Weiss H-R, Rigo M. Expert-driven Chêneau applications: description and in-brace corrections. Physiother Theory Pract. 2011;27(1):61–67.
Weiss H-R, Weiss G. Brace treatment during pubertal growth spurt in girls with idiopathic scoliosis (IS) – a prospective trial comparing two different concepts. Pediatr Rehabil. 2005;8(3):199–206.
Weiss H-R, Weiss G, Schaar HJ. Incidence of surgery in conservatively treated patients with scoliosis. Pediatr Rehabil. 2003;6:111–118.
Weiss H-R, Werkmann M. Brace technology thematic series: the ScoliOlogiC® Cheneau lightTM brace in the treatment of scoliosis. Scoliosis. 2010;5:1.
Weiss H-R, Werkmann M, Stephan C. Brace related stress in scoliosis patients: comparison of different concepts of bracing. Scoliosis. 2007;20(2):10.
Weiss H-R, Werkmann M, Stephan C. Correction effects of the ScoliOlogiC Chêneau light brace in patients with scoliosis. Scoliosis. 2007;26(2):2.
Wong MS, Cheng JC, Lam TP, Ng BK, Sin SW, Lee-Shum SL, et al. The effect of rigid versus flexible spinal orthosis on the clinical efficacy and acceptance of the patients with adolescent idiopathic scoliosis. Spine. 2008;33(12):1360–1365.
Wong MS, Cheng JC, Lo KH. A comparison of treatment effectiveness between the CAD/CAM method and the manual method for managing adolescent idiopathic scoliosis. Prosthet Orthot Int. 2005;29(1):105–111.
Zaborowska-Sapeta K, Kowalski IM, Kotwicki T, Protasiewicz-Fałdowska H, Kiebzak W. Effectiveness of Chêneau brace treatment for idiopathic scoliosis: prospective study in 79 patients followed to skeletal maturity. Scoliosis. 2011;6(1):2–5.
Zaborowska-Sapeta K, Kowalski IM, Protasiewicz-Fałdowska H, Wolska O. Evaluation of the effectiveness of Chêneau brace treatment for idiopatic scoliosis – own observations. Pol Ann Med. 2010;17(1):44–53.
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