Effectiveness of the Rigo Chêneau versus Boston-style orthoses for adolescent idiopathic scoliosis: a retrospective study.
BACKGROUND
Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type. We compared outcomes of AIS patients treated with Rigo Chêneau orthoses (RCOs) or custom-molded Boston-style thoracolumbosacral orthoses (TLSOs).


METHODS
We retrospectively reviewed patient records from one scoliosis center from 1999 through 2014. Patients were studied from initial treatment until skeletal maturity or surgery. Inclusion criteria were a diagnosis of AIS, initial major curve between 25° and 40°, use of an RCO or TLSO, and no previous scoliosis treatment.


RESULTS
The study included 108 patients (93 girls) with a mean (±standard deviation) age at brace initiation of 12.5 ± 1.3 years. Thirteen patients wore an RCO, and 95 wore a TLSO. Mean pre-bracing major curves were 32.7° ± 4.8° in the RCO group and 31.4° ± 4.4° in the TLSO group (p= 0.387). Mean brace wear time was similar between groups. Mean differences in major curve from baseline to follow-up were -0.4° ± 9.9° in the RCO group and 6.9° ± 12.1° in the TLSO group (p= 0.028). Percent changes in major curve from baseline to follow-up were 0.0% ± 30.5% for the RCO group and 21.3% ± 38.8% for the TLSO group (p= 0.030). No RCO patients and 34% of TLSO patients progressed to spinal surgery (p= 0.019). At follow-up, major curves improved by 6° or more in 31% of the RCO group and 13% of the TLSO group (p= 0.100).


CONCLUSIONS
Patients treated with RCOs compared with Boston-style TLSOs had similar baseline characteristics and brace wear time yet significantly lower rates of spinal surgery. Patients with RCOs also had lower mean and percent major curve progression versus those with TLSOs.
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD USA.
Miriam K
MK
Minsk
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD USA.
Kristen D
KD
Venuti
Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD USA.|Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, MD USA.|Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.|Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
Gail L
GL
Daumit
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD USA.|Bloomberg Children's Center, 1800 Orleans Street, 7359A, Baltimore, MD 21287 USA.
Paul D
PD
Sponseller
Adolescent; Bracing; Major curve; Orthosis; Outcomes; Scoliosis