Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Eur Spine J. 2022 Apr;31(4):980-989. doi: 10.1007/s00586-022-07131-z. Epub 2022 Feb 21.
Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types.
Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies' officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM.
The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction-valves (monocot, bivalve, multisegmented), construction-closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups.
The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.
研究表明，支具是治疗特发性脊柱侧凸患者的有效方法。根据目前的分类，几乎所有的支具都属于胸腰骶支具（TLSO）范畴。因此，科学研究结果的推广要么不可能，要么具有误导性。本研究旨在对支具类型进行分类。
四个科学协会（SOSORT、SRS、ISPO 和 POSNA）邀请其所有成员参与这项研究。六位一级专家制定了初步分类。在一次有 26 位其他专家和协会官员参加的共识会议上，通过主题分析和一般性讨论，定义了分类（至少 80%的专家达成一致）。该分类应用于文献中发表的支具，并得到了四个科学协会和 ESPRM 的正式批准。
该分类基于以下分类项目：解剖结构（CTLSO、TLSO、LSO）、刚性（非常刚性、刚性、弹性）、主要矫正平面（额状面、矢状面、水平面、额状面和矢状面、额状面和水平面、矢状面和水平面、三维）、结构-瓣（单瓣、双瓣、多瓣）、结构-闭合（背侧、外侧、腹侧）和主要作用（弯曲、解旋、伸长、运动、推起、三点）。专家们为每个项目制定了定义，并能够将 15 种已发表的支具分为九组。
该分类基于当前最佳专业知识（最低水平的证据）。专家们认识到，这是第一版，随着未来的理解和研究，它将发生变化。该分类的广泛应用可能对支具研究、教育、临床实践以及该领域的发展具有价值。
