RESULTS OF 390 JUVENILE AND ADOLESCENT IDIOPATHIC SCOLIOSIS IN ACCORDANCE
WITH SRS CRITERIA TREATED BY THE NEW LYON ARTBRACE AND REVIEWED AT 6 MONTHS.
Authors and Institutions: De Mauroy JC, Gagliano F, Barral F, Pourret S.
Introduction: The ARTbrace is a technological evolution of the classic
Lyon conservative treatment with replacement of the Elongation Derotation
Flexion plaster cast by a digital cast allowing the design of an asymmetrical
brace with very high rigidity. The comparison with the old Lyon brace has
demonstrated the superiority of the ARTbrace. Four years after the first
ARTbrace more than 1000 patients have been treated with this new brace.
With ARTbrace, a previous study shows also that there is a correlation close to
0.9 between the angulation 6 months after fitting the brace and the final result
2 years after weaning the brace. Landauer and Aulisa showed also a predictive
correlation at 6 months.
For scoliosis of more than 40°, the results at 6 months were significantly
superior to those of the old Lyon brace. The SRS and SOSORT criteria allow
comparison of results with other braces.
Objective(s): The aim is to present the results of Cobb angle at the
first 3 stages of treatment: 1. initial, 2. immediate in-brace correction and 3.
without brace at 6 months.
Method(s): 748 patients were treated with ARTbrace from May 2013 to March 2017.
413 patients responded to the SRS and SOSORT criteria. 23 drop-outs (6%) were
excluded and 390 consecutive patients (318 females & 72 males) were selected
from our prospective database. The Cobb curve magnitude (CM) of the 507
primitive curves (279 thoracic and 228 lumbar) is registered before bracing
(t1), in-brace (tB)and at 6 months without brace (t2). Lenke 5 lumbar curves are
excluded as treated by the short GTB brace.
Design: Case series of all consecutive patients. All descriptive
parameters are studied with the SPSS v20 package.
Result(s) and Discussions: The average age of patients was 13.5 years (SD
The results of our study showed that for the Thoracic curves CM mean value was
30.06 ± 6.78 SD at t1, 10.82 ± 6.82 SD at tB and 20.03 ± 7.39 SD at t2.
The average results of our study showed that for the Lumbar curves CM mean value
was 28.70 ± 7.40 SD at t1, 7.65 ± 7.12 SD at tB and 17.00 ± 7.67 SD at t2.
The results for all 507 primitive curves was: 29.45 ±5.07 SD at t1, 9.40 ± 7.13
SD at tB and 18.65 ± 7.66 SD at t2.
The average percentage of correction was 69.2% at tB and 37.6% at t2, identical
to our previous publications. (Figure 1)
At t2 Curve correction was accomplished in 333 patients (85.4%), stabilization
was obtained in 54 patients (13.8%), 3 patients have a progression (0.76%).
The drop-out rate is low and probably related to the initial motivation of
patients who are aware of avoiding the plaster cast.
The initial average angulation of 30°, the in-brace correction of 70%, and the
correction of more than 30% without brace at 6 months are identical to that of
the general statistics.
The in-brace correction is superior to other asymmetric braces such as the
Chêneau brace (40%) probably related to the very high rigidity of polycarbonate
and the design from digital cast. The results at 6 months without brace are also
better than those published and seem to confirm the correlation between the
immediate in-brace correction and the final result of the treatment.
Conclusion(s) and Significance: Our study confirms the improvement of the
results compared to the old Lyon brace with the possibility of avoiding the
plaster cast with the digital cast in 3 blocks. They can only encourage the
patient to continue the treatment with good compliance.