Serial CAD/CAM Bracing: An Alternative to Serial Casting for Early Onset Scoliosis. J Pediatr Orthop 2019 Mar;39(3):e185-e189
Date
10/26/2018Pubmed ID
30358691DOI
10.1097/BPO.0000000000001287Scopus ID
2-s2.0-85055670322 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
BACKGROUND: Years of casting for infantile scoliosis can lead to significantly detrimental quality of life for both the child and parents. Concerns have been raised about the long-term negative neurodevelopmental effects of repeated anesthesia on young children. We developed an elongation bending derotation brace (EBDB) that uses primarily a bending derotation force applied to the curve to achieve the same goals as the cast. The goal of the study is to describe the preliminary results of a technique for creation of EBDB for infantile idiopathic scoliosis using computer-aided design/computer-aided milling (CAD/CAM) technology with at least 24 months follow-up.
METHODS: Nine patients with infantile idiopathic scoliosis had minimum 2-year follow-up (mean, 3.4 y; range, 2 to 6 y). Mean age at the treatment was 11 months (4 to 24 mo). There were 2 right thoracic, 7 left thoracic curves. CAD/CAM technology was used to create the EBDB after the child was placed in traction and a derotation strap applied. The same rotational forces that are used in the creation of the Mehta-type cast can also be utilized in creating the brace. A laser scanner was used to obtain the spinal geometry. Compliance can be monitored with a heat sensor.
RESULTS: Four patients were full corrected with serial bracing alone (curve ≤10 degrees). Five patients with more rigid curves showed improvement from mean 57 degrees (48 to 62 degrees) to mean 21 degrees (10 to 44 degrees).
CONCLUSIONS: This paper describes the preliminary results of a new methodology for creating a patient-specific brace for infantile scoliosis using CAD/CAM technology. This methods shows promising potential to treat the infantile curve without the drawbacks of casting.
LEVEL OF EVIDENCE: Level IV.
Author List
Thometz J, Liu XCAuthors
Xue-Cheng Liu PhD Professor in the Orthopaedic Surgery department at Medical College of WisconsinJohn G. Thometz MD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
BracesChild, Preschool
Computer-Aided Design
Female
Follow-Up Studies
Humans
Infant
Male
Patient Compliance
Prosthesis Design
Scoliosis
Treatment Outcome
