title: The outcome of a modified version of the Cheneau brace in adolescent idiopathic scoliosis (AIS) based on SRS and SOSORT criteria: a retrospective study.
abstract: BACKGROUND
  Bracing therapy for patients with adolescent idiopathic scoliosis (AIS) continues to be a controversial issue. As a consequence, to achieve an adequate level of evidence, there is a strong need for specific studies conducted according to standard outcome and management criteria.
  
  
  OBJECTIVE
  To assess the outcomes of a modified version of the Cheneau brace, ("Cheneau-P") in patients with AIS, based on SRS and SOSORT criteria.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Scoliosis Unit of a Clinical Center.
  
  
  METHODS
  Sixty-seven patients, 56 females and 11 males.
  
  
  METHODS
  Inclusion criteria were: diagnosis of AIS, age ≥10 years, Risser Score 0-2, Cobb degrees 20-40, no previous treatment, beginning of brace treatment within 1 year after menarche and minimum 2-year follow-up. According to SRS criteria, bracing outcomes were classified, as follows: "improved" (reduction of the curve ≥6°), "unchanged" (5° curve progression or reduction), "worsened" (≥6° curve progression), and "over 45°" (curve exceeding 45° or undergone surgery during the follow-up). The outcomes "improved" and "unchanged" were considered as successful outcomes. Groups and related subgroups were created according to curve type (thoracic, thoraco-lumbar, lumbar and double major) and magnitude (20°-30°; 30°-40°) and to skeletal age (Risser score 0, 1, 2). A separate analysis was also performed on the 37 patients, 30 females and 7 males, who completely fulfilled the SRS eligibility criteria, showing spinal curves between 25 and 40 Cobb degrees.
  
  
  RESULTS
  In the whole group SRS outcome after bracing treatment was successful in 93% and in 81% of patients, at per protocol (PP) and intention to treat (ITT) analysis, respectively, the latter also including drop-outs as worst outcomes. Cobb angles significantly decreased in all subgroups except in patients showing double major curves, lower curve magnitude (20-30°) and Risser score 2. Rib humps and balance rate also significantly improved in the whole sample (12.78±4.54 at T0 vs. 6.83±4.33 at T1 P<0.001; 60% at T0 vs. 94% at T1 P<0.001, respectively). In the subgroup that completely fulfilled the SRS eligibility criteria, the outcome was successful in 92% and 83% of patients, at PP and ITT analysis, respectively, the latter also including, even in this case, drop-outs as worst outcomes.
  
  
  CONCLUSIONS
  This study shows that in patients with AIS the treatment with the "Cheneau-P" brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria.
  
  
  CONCLUSIONS
  The "Cheneau-P" brace proved effective as a conservative treatment for AIS by stabilizing curve progression and limiting the need for surgical treatment.
authors.affiliation: Don Gnocchi Foundation, Florence, Italy - gpasquini@dongnocchi.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Pasquini
authors.forename: Francesca
authors.initials: F
authors.lastname: Cecchi
authors.forename: Christian
authors.initials: C
authors.lastname: Bini
authors.forename: Raffaello
authors.initials: R
authors.lastname: Molino-Lova
authors.forename: Federica
authors.initials: F
authors.lastname: Vannetti
authors.forename: Chiara
authors.initials: C
authors.lastname: Castagnoli
authors.forename: Anita
authors.initials: A
authors.lastname: Paperini
authors.forename: Roberta
authors.initials: R
authors.lastname: Boni
authors.forename: Claudio
authors.initials: C
authors.lastname: Macchi
authors.forename: Biase
authors.initials: B
authors.lastname: Crusco
authors.forename: Simone
authors.initials: S
authors.lastname: Ceppatelli
authors.forename: Alvaro
authors.initials: A
authors.lastname: Corigliano
mesh_terms: D000293:Adolescent; D001915:Braces; D002648:Child; D015331:Cohort Studies; D000072700:Conservative Treatment / Q000379:methods*; D004185:Disability Evaluation; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012600:Scoliosis / Q000175:diagnosis* / Q000534:rehabilitation*; D012720:Severity of Illness Index; D016896:Treatment Outcome