1 / 18

Concepts of Bracing Adolescent Idiopathic Scoliosis

Concepts of Bracing Adolescent Idiopathic Scoliosis. David Speers, CPO,LPO Scheck and Siress. Scoliosis coronal plane deformity (primarily). Congenital – present at birth due to anomalies in the vertebrae (hemi-vertebrae)

trilby
Download Presentation

Concepts of Bracing Adolescent Idiopathic Scoliosis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Concepts of Bracing Adolescent Idiopathic Scoliosis David Speers, CPO,LPO Scheck and Siress

  2. Scoliosiscoronal plane deformity (primarily) Congenital – present at birth due to anomalies in the vertebrae (hemi-vertebrae) Neuromuscular – deformity due to weakness or paralysis (cerebral palsy, spina bifida) Idiopathic – (infantile, juvenile, adolescent) – unknown cause

  3. When to brace(Scoliosis Research Society Guidelines) • Skeletally Immature Patients (Risser 0,1,2) • Curves with the magnitude of 25-40 degrees • Curves over 20 degrees with documented progression

  4. A Brief Review of Natural History (untreated adolescent idiopathic scoliosis)…. Lonstein :1984 JBJS Risk of Progression(Percent) RISSER SIGN 5-19° 20-29° 30° 0,1 22% 68% 90+% 2,3,4 1.6% 23% 50-70%

  5. Assessing skeletal maturity:Risser Sign

  6. Bracing Concepts for scoliosis • TLSO (thoraco-lumbar-sacral orthosis) • Three point pressure system to correct the curve(s) • Daytime,night time, both • Anterior or posterior open designs

  7. Expectations for scoliosis bracing • Brace to prevent progression of the scoliotic curve(s) during growth • Curve will be corrected in the brace (40-50% daytime, 90-100% night time brace) • Curve will be present when brace is removed

  8. Out of Brace vs. In Brace

  9. Out of Brace vs. In Brace

  10. Many styles of scoliosis tlso braces

  11. Daytime tlso concepts • 3 point pressure system • 16 – 23 hour wear • Can be worn at night as well • Made from CAD measurements or molding

  12. Essential componentsDaytime tlso Axillary Pad Thoracic Pad Lumbar Pad Trochanteric Extension

  13. Night time tlso concepts • “over correction” with lower wear time • 90 – 100% correction achieved • Providence and Charleston styles • Single curves • Increased compliance

  14. Night time tlso Providence TLSO Charleston TLSO “bending brace”

  15. When to discontinue(skeletal maturity) • Look for plateau in height • Risser sign (4 or 5) • Menstrual cycle: 1.5 – 2 years after start • Tri radiate cartilage in hips should be closed • Check height of parents if possible • Girls mature sooner than boys

  16. Wear time monitors(temperature) Tidbit I-button (Maxim)

  17. Wear time monitors • Placed inside of the brace • Monitors average hours worn • Displays 24 hour wearing profile • Graphs daily hourly use • Accurately shows how the brace is being worn

  18. Thank you

More Related