[Evaluation of the efficacy of a carbon brace ("Corset monocoque carbone respectant la respiration" [CMCR]) preserving lung capacity to treat idiopathic scoliosis in children and adolescents: a retrospective study of 115 patients]

Abstract

Objectives: The purpose of this retrospective study was to investigate whether treatment with a carbon brace (CMCR) stops the progression of idiopathic scoliosis in children and adolescents affected by combined or thoraco-lumbar scoliosis.

Method: We compared clinical features (hump and vital capacity) and radiolographic data (Cobb angle, sacral slope, lumbar lordosis and thoracic kyphosis) at brace set-up and removal in 115 children and adolescents with combined or thoraco-lumbar scoliosis. The impact of the brace was evaluated in 2 subgroups: patients who started the treatment at Risser stages 0, 1 or 2 and those who started the treatment at Risser stages 3 or 4. With 95 patients, a questionnaire was used to evaluate the physical and psychological tolerance of the brace and technical difficulties during treatment with the orthosis.

Results: At brace set-up, the immediate angular correction was about 50% compared to the pre-brace angle; the reduction of the vital capacity was weak. After brace removal, radiographic data showed significant improvement in thoraco-lumbar scoliosis and in the lumbar curve of patients with combined scoliosis, although the thoracic curvature of the combined scoliosis was unchanged. No significant efficiency on the hump was observed.

Conclusion: The CMCR brace can stop the progression of moderate combined or thoraco-lumbar scoliosis in growing children and adolescents, with little consequence to vital capacity, but seems to have no efficacy on the hump. This type of orthosis provides a better outcome in terms of thoracic mobility and vital capacity. The CMCR brace is indicated for children and growing teenagers with flexible, progressive scoliosis. This "mobile" brace definitely has its place in the current therapeutic arsenal.