[Conservative treatment of idiopathic scoliosis : Influence of archetypical Cheneau-Corsets on trunk asymmetry]. / Konservative Behandlung der idiopathischen Skoliose : Beeinflussung der Rumpfasymmetrie mit Cheneau-Korsettarchetypen.

BACKGROUND: The vertical posture of the growing child requires minute central nervous control mechanisms to maintain the symmetry of the torso in its various activities. Measuring only static parameters such as the Cobb angle does not describe the dynamic changes of scoliotic deformities in gait. A constant deviation in the frontal, transverse, and sagittal planes from the dynamic symmetry of the trunk is described in motion analysis and the surface changes of the spinopelvic complex. METHODS: Early intervention with effective bracing, physiotherapy and sport can reverse curve progression in growth spurts, once these are identified by screening. Modern braces have a derotating and reducing effect ("mirror effect") on asymmetric body volumes, thus influencing the growing torso and restoring lasting symmetry. These braces can be reduced for archetypical designs. Latest data support the use of braces to reverse progressing scoliosis.

[Conservative treatment of idiopathic scoliosis with effective braces: early response to trunk asymmetry may avoid curvature progress]. / Konservative Therapie der idiopathischen Skoliose mit dem Korsett : Hohe Korrekturraten bei frühzeitiger Beobachtung und Behandlung der Rumpfasymmetrie.

Vertical posture of the growing child requires minute central nervous control mechanisms in order to maintain symmetry of the torso in its various activities. Scoliosis describes a constant deviation in the frontal, transverse and sagittal planes from the dynamic symmetry of the trunk. Early intervention with effective bracing, physiotherapy and sports can reverse curve progression during growth spurts, once these are identified in screening. Modern braces have a derotating and reducing effect (mirror effect) on asymmetric body volumes, thus influencing the growing torso and restoring lasting symmetry. Recent data support the use of braces to reverse progressing scoliosis.

[2- and 3-dimensional correction of scoliosis by corset treatment. Optimized conservative therapy of idiopathic scoliosis with the improved Cheneau corset]. / Zwei- und dreidimensionale Korrektur von Skoliosen durch Korsettbehandlung. Optimierte konservative Therapie der idiopathischen Skoliose durch ein weiterentwickeltes Cheneau-Korsett.

It is generally accepted that the progression of an idiopathic scoliotic deformity with a Cobb angle of between 25 degrees and 40 degrees can be stopped by brace treatment alone provided that the generally acknowledged criteria for the treatment concerning skeletal growth of the individual are respected. In Europe, the Cheneau brace, which was originally designed as an active derotation orthosis, is widely in use and is constantly being improved. The biomechanical principle of this orthosis consists of a pressure vector that is applied laterally (with regard to the 3-point principle) to exert pressure on the peak of the curvature in the frontal and transversal planes. Thus, the thoracic, lumbar and pelvic body mass that was rotated out of normal body symmetry is transferred back to its original position via pressure and derotation. Therefore, an active back like the Cheneau orthosis must provide pressure surfaces and sufficient expansion spaces. Subtle insights into the actual effect of braces have furthered ongoing development to take into consideration the changes to the trunk in the sagittal plain and have respected the different states of expansion of the two halves of the trunk in the craniocaudal direction. The thoracic flat back and cyphosis of the lumbal spine, which were formerly ignored, actually provide a real challenge for the technical realization of the brace. The new generation of Cheneau braces potentially provides an effective means for the active correction of scoliotic spinal deformity in all three dimensions and thus fulfills the requirements of modern conservative scoliosis treatment.