Comparisons of the immediate radiographic results between wearing a custom-made thoracolumbosacral orthosis with and without a dynamic thoracic pad for a dolescent idiopathic scoliosis patients: A case series study

Abstract

One of the most common pathologies in adolescents is adolescent idiopathic scoliosis (AIS). Spinal orthosis is a treatment option for delaying the progression of the curve. Based on the characteristics of the padding inside the orthosis, it can be divided into three groups: no padding, static padding, and dynamic padding. The Rosenberger brace is one type of spinal orthosis with a movable or dynamic pad; however, very few studies have been done on this design. The study fabricated a custom-made thoracolumbosacral orthosis (TLSO) based on the Boston principle concept with a movable thoracic pad following the Rosenberger brace concept. Therefore, the objective of the study was to compare the immediate radiographic results between wearing a custom-made TLSO with a dynamic thoracic pad (design 2) and without a dynamic thoracic pad (design 1) in AIS patients in terms of the Cobb angle, apical translation, and coronal decompensation reduction. This was a case-series study involving three AIS patients who were fitted with custom-made TLSO designs 1 and 2, and with an in-brace X-ray immediately taken for both interventions. The Cobb angle, apical translation, and coronal decompensation were measured and compared with the most recent out-of-brace X-ray. The results illustrated that the TLSO design 2 showed better results in terms of the Cobb angle reduction at both the thoracic and lumbar curves. For the apical translation reduction of TLSO design 2, it presented better results for participants 1 and 3 at the thoracic curve and at the lumbar curve for participants 1 and 2. In terms of coronal decompensation reduction, TLSO design 1 performed better than design 2 among participants 1 and 2. However, TSLO design 2 performed better in participant 3. Overall, both designs showed improvements in the Cobb angle, apical translation, and coronal decompensation. TLSO design 2 showed better results in reducing the Cobb angle and apical translation compared to TLSO design 1. The result of TLSO design 2 shows the high potential effectiveness of brace treatment. In the next step, a long-term study with a large group of scoliosis patients would be recommended, which would include assessing the quality of life of patients, as well as patient compliance.