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. 2013 Feb 14;8(1):3.
doi: 10.1186/1748-7161-8-3.

The carbon brace

Jean-Claude Bernard  1 , Cyril Lecante, Julie Deceuninck, Gregory Notin, Lydie Journoud, Frederic Barral
Affiliations

The carbon brace

Jean-Claude Bernard et al. Scoliosis. .

Abstract

Background: The CMCR brace (Corset MonocoqueCarbone respectant la Respiration -which means Monoshell Carbon Brace respecting Breathing) is an innovative brace, used in orthopaedic treatment for progressive thoracic, thoraco-lumbar or combined scoliosis, whatever their etiology. It can be used at the very young age without disrupting the chest growth, but should be kept for reducible scoliosis in older teenagers. BRACE DESCRIPTION AND PRINCIPLES: The CMCR brace is monoshell while retaining the corrective principle of the polyvalve Lyon brace with one or two supports (brace "pads") located on hump(s).In contrast to Lyon brace made of plexidur and structured by metal reinforcement with adjustable but fixed localized supports, the CMCR brace is made of polyethylene and carbon with adjustable and mobile supports. This mobility provides a permanent pressure, which varies depending on ribs and spine movements.The correction is obtained without spinal extension so that each respiratory movement takes part in a gradual return to dorsal kyphosis.

Results: Results were presented in two published analysis:• In the first retrospective study about 115 patients, French-published in the Annals of Physical Medicine and Rehabilitation (2005), the CMCR brace stabilized moderate scoliosis, decreased the vital capacity (VC) of 13% compared to the VC without brace, and did not have sufficient impact on the hump reduction. Treatment had better results when started at Risser 3 or 4 than Risser 0, 1, 2. The brace was then modified to increase the dorsal pad pressure and the location of correction forces was defined more precisely through the use of 3D analysis.• The second study published in Scoliosis (2011) mainly focused on the impact on VC at brace setting up and followed a cohort of 90 patients treated with CMCR. Girls as well as boys increased VC during treatment, and at brace definitive removal, VC had increased of 21% from the initial value, whereas the theoretical VC at the same time rose by 18%.The difference between the time where the child actually wears its brace and the time asked by the clinician for the brace to be worn is only 1 hour, which means that this brace is accepted by teenagers.

Conclusions: Orthopaedic treatment is still a heavy treatment for teenagers in growth period. This orthosis is designed to partly maintain spine and chest mobility. We hope so to have part in improving life conditions of these teenagers, compared to those treated with rigid braces.

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Figures

Figure 1
Figure 1
Diagram for brace indications regarding age and Cobb angle.
Figure 2
Figure 2
Localization of pressure.
Figure 3
Figure 3
Three kydex support pieces; 2 side ones, and 1 posterior.
Figure 4
Figure 4
Front view of the main shell.
Figure 5
Figure 5
Left lumbar pad.
Figure 6
Figure 6
Right thoracic pad.
Figure 7
Figure 7
Three-dimensional scanning unit (ORTEN optical sensor).
Figure 8
Figure 8
Patient positioning during optical print acquisition.
Figure 9
Figure 9
Fringe used for the 3D thorax reconstruction.
Figure 10
Figure 10
3D thorax reconstruction.
Figure 11
Figure 11
Milling different steps in rectifying positive.
Figure 12
Figure 12
Numerically controlled milling machine.
Figure 13
Figure 13
Fitting thepolyethylene shell.
Figure 14
Figure 14
Posterior and front views of the shell after fitting.
Figure 15
Figure 15
Different steps in CMCR assembly.
Figure 16
Figure 16
Physical therapy training in CMCR.
Figure 17
Figure 17
Face and profile x-rays without brace. Thoraco-lumbar scoliosis.
Figure 18
Figure 18
CMCR with right thoraco-lumbar pad.
Figure 19
Figure 19
Face and profile x-raysin CMCR.
Figure 20
Figure 20
Face and profile x-rays without brace. Double-major scoliosis.
Figure 21
Figure 21
CMCR with right thoracic pad and left lumbar pad.
Figure 22
Figure 22
Face and profile x-raysin CMCR.
See this image and copyright information in PMC

References

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