NEW TRIAC™-BRACE FOR CONSERVATIVE TREATMENT OF IDIOPATHIC SCOLIOSIS – AN ALTERNATIVE OPTION?

Abstract

Introduction: Veldhuizen (2002) developed a new flexible Scoliosis-Brace for effective curve correction in Idiopathic Scoliosis. This new Brace is characterised by a improved cosmetic appearance and wearing comfort compared to conventional ortheses (Cheneau, Boston).

We investigated the effectiveness of the TriaC™-Brace regarding the primary curve correction in Idiopathic Scoliosis (IS).

Materials and Method: Following the guidelines given by Veldhuizen (2002) we have treated 20 patients (15 girls, 5 boys, average age: 12,43) with diagnosis of IS (King I:6, King II:4, King III:8, King IV:1, lumbar:1) with the TriaC™-Brace from 2002–2004.

At the beginning of the therapy with the new orthesis the Risser sign was 2,68 at an average.

The daily wearing time was instructed with 22–23 hours.

Lumbar curves showed an average cobb angle of 26,1 degrees (standard deviation=8,6) and thoracic curves of 24,4 degrees (standard deviation=6,5).

The radiological assessment of primary curve correction (cobb-angle) was performed 6,2 weeks after the beginning of the therapy (anterior posterior radiograph of the spine in standing position with orthesis).

Further radiological controls were performed every six months. We evaluated the wearing time, comfort and leisure activity with a valid scoring system (Quality of Life Profile for Spine Deformities).

The overall mean wearing time of the Triac™-Brace was 14,7 months.

Results: For lumbar curves (n=12) we measured a primary correction of 9,9 degrees (40%; statistically significant, t-test, p=0,01) and for thoracic curves (n=20) of 2,2 degrees (8,4%; not statistically significant, t-test, p=0,42).

A insufficient primary curve correction (defined as < 30% of the initial cobb-angle) was observed in 16 thoracic curves (89%) and in 4 lumbar curves (30%).

An increasing correction during the therapy as reported by Veldhuizen (2002) could not be observed.

There was a curve progression of at least 5 degrees of the cobb-angle in 4 cases.

The evaluation by the scoring system (response in 85%) resulted in a high score for cosmetics (4,2/5) and mobility of the back (4,6/5). The wearing time was reported by 90% of the patients with 22–23h.

Conclusion: We do not recommend the conservative therapy of thoracic or double curves (King III, King I and II) with the TriaC™-Brace.

Larger studies are necessary to investigate the effectiveness of the orthesis in lumbar curves. The improved wearing comfort and cosmetics are a potential advantages of this new orthesis.