title: Scoliosis in-brace curve correction and patient preference of CAD/CAM versus plaster molded TLSOs.
abstract: OBJECTIVE
  CAD/CAM technology is a newer technique for creating spinal orthoses than standard plaster molded methods. To our knowledge there has been only one previous study of CAD/CAM braces. The purpose of our study was to compare patient preference and in-brace correction of Cobb angle between plaster molded thoracolumbosacral orthoses (TLSO) and CAD/CAM designed TLSOs in a series of patients with scoliosis.
  
  
  METHODS
  Ten patients with an average initial Cobb angle of 30.8 degrees (range 18 degrees -46 degrees ) had both a plaster molded TLSO and a CAD/CAM TLSO fabricated for them. In each case, the decision to brace was made by the treating surgeon based on curve magnitude and skeletal maturity. After 3 weeks of 23 h a day wear, in-brace correction of the Cobb angle was measured for each brace based on standard PA spine radiographs. After 3 months of use, patients were asked which brace they preferred.
  
  
  RESULTS
  For the CAD/CAM brace, the mean curve correction after 3 months was 51% compared to 44% in the plaster molded TLSO cohort. (p = 0.46). Seven out of nine patients preferred the CAD/CAM TLSO over the plaster molded TLSO. There were no brace complications in either group.
  
  
  CONCLUSIONS
  In our matched cohort study, CAD/CAM TLSOs had at least equivalent if not superior correction of the Cobb angle compared to standard plaster molded TLSOs; 78% of our patients preferred the CAD/CAM brace over the standard TLSO.
authors.affiliation: Children's Hospital Los Angeles, 4650 Sunset Boulevard #69, Los Angeles, CA, 90027, USA.
authors.forename: Wudbhav N
authors.initials: WN
authors.lastname: Sankar
authors.forename: Josh
authors.initials: J
authors.lastname: Albrektson
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lerman
authors.forename: Vernon T
authors.initials: VT
authors.lastname: Tolo
authors.forename: David L
authors.initials: DL
authors.lastname: Skaggs