Weiss Hans-Rudolf, Rigo Manuel
Asklepios Katharina Schroth Spinal Deformities Rehabilitation Centre, Korczakstr. 2, 55566 Bad Sobernheim, Germany.
Stud Health Technol Inform. 2008;135:291-302.
In-brace correction and compliance are the main predictors of a successful outcome of brace treatment in the management of patients with Idiopathic scoliosis. The latest CAD/CAM or module based bracing concepts, related to a proper classification have lead to a better in-brace correction and have made the braces easier to wear for the patient. Nevertheless, the latest developments on the market do not allow successful treatment in every case. The latest biomechanical models of brace correction therefore may lead to a differential indication for certain concepts described in this paper. Thoracic curves with Cobb angles < 50 degrees may be treated with the best possible success with the latest Chêneau derivates enabling a real 3D-correction including also the sagittal correction of the spine. The application of those braces demands a proper classification of curve patterns. Thoracic curves with Cobb angles > 50 degrees demand to increase the force vector from dorsal with the ventral counteraction of subclavicular pads both sides, although this may be at the cost of sagittal correction. The percentage of in-brace correction is a good indicator for brace action, however in the individual case this is not always the most important factor.
支具内矫正和依从性是特发性脊柱侧凸患者支具治疗成功结果的主要预测因素。最新的基于计算机辅助设计/制造（CAD/CAM）或模块的支具概念，结合适当的分类方法，已带来更好的支具内矫正效果，并使患者佩戴支具更加舒适。然而，市场上的最新进展并不能确保在每种情况下都能成功治疗。因此，支具矫正的最新生物力学模型可能会导致本文所述某些概念的不同适应证。对于Cobb角<50度的胸段曲线，使用最新的Cheneau衍生支具可能会取得最佳治疗效果，该支具能够实现真正的三维矫正，包括脊柱矢状面的矫正。使用这些支具需要对曲线类型进行适当分类。对于Cobb角>50度的胸段曲线，需要增加来自背部的力向量，并通过两侧锁骨下垫的腹侧反作用来实现，尽管这可能会以矢状面矫正为代价。支具内矫正的百分比是支具作用的一个良好指标，但在个别情况下，这并不总是最重要的因素。
