Lyon brace

Abstract

For the last 60 years, the impressive progress of the scoliosis surgery has hidden the development of the conservative orthopedic treatment. The stabilization of the scoliosis, which implies the safeguarding of a spine as mobile as possible, remains a valid objective. The Lyon Brace management combines 3 techniques. A reduction of the scoliosis using a plaster cast fixed on an EDF (Elongation Derotation Flexion) Cotrel's frame. It carries through a flow of the musculoligamentar structure of the concavity. A contention by Lyon Brace. Orthesis without any cervical superstructure is adjustable, symmetric, see through and active. The elongation between the two scapular and pelvic girdle leads to a disc decompression which makes easier the 3D correction of the curves. The individual moulding (custom made) is actually electronic using a "full 3D imaging" system by Orten. To every 14 types of Lenke's classification matches a specific blue print. A specific physiotherapy combining the consciousness of the deformity, suppling up of the retracted elements of the concavity, compensatory suppling up of the girdles, improvement of the vital capacity based on exhalation, reharmonisation of the static, static strengthening in order to facilitate the ability to be still in a corrected position, kyphotisation proprioceptive exercises to stimulate the maturation of the postural system. We advise the scoliotics to practice sport during the treatment period. The long term follow up confirms a global effectiveness indication of 0,89 with the rib hump declining by half. When we treat scoliotics with Cobb angle less than 45 degrees, surgical treatment can be prevented in 98% of the patients.In France 60% of the families agree with this stringent treatment which becomes easier thanks to its ambulatory realization and the excellent formation of the partners, the physiotherapists and the orthesist.