Stefano Negrini1,2, Angelo Gabriele Aulisa3, Pavel Cerny4, Jean Claude de Mauroy5, Jeb McAviney6, Andrew Mills7, Sabrina Donzelli8, Theodoros B Grivas9, M Timothy Hresko10, Tomasz Kotwicki11, Hubert Labelle12, Louise Marcotte13, Martin Matthews14,15, Joe O'Brien16, Eric C Parent17, Nigel Price18, Rigo Manuel19, Luke Stikeleather20, Michael G Vitale21, Man Sang Wong22, Grant Wood23, James Wynne24, Fabio Zaina8, Marco Brayda Bruno25, Suncica Bulat Würsching26, Caglar Yilgor27, Patrick Cahill28, Eugenio Dema29, Patrick Knott30, Andrea Lebel31, Grigorii Lein32, Peter O Newton33, Brian G Smith34. 1. Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy. Stefano.negrini@unimi.it. 2. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Stefano.negrini@unimi.it. 3. IRCCS Bambino Gesù Children's Hospital, Rome, Italy. 4. West Bohemia University, Pilsen, Czechia. 5. Independent Researcher, Lyon, France. 6. ScoliCare, Kogarah, NSW, Australia. 7. Sheffield Children's NHS Foundation Trust, Sheffield Children's Hospital, Sheffield, UK. 8. ISICO (Italian Scientific Spine Institute), Milan, Italy. 9. Department of Orthopedics and Traumatology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece. 10. Boston Children Hospital, Harvard Medical School, Boston, MA, USA. 11. Spine Disorders and Pediatric Orthopedics Department, University of Medical Sciences, Poznan, Poland. 12. Division of Orthopedics, University of Montreal, CHU Sainte-Justine, Montréal, QC, Canada. 13. OrthoChiro, Montréal, QC, Canada. 14. DM Orthotics Ltd, Redruth, UK. 15. School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK. 16. SOSORT, Boston, MA, USA. 17. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada. 18. Children's Mercy Hospital, Kansas City, MO, USA. 19. Rigo Quera Salvá, SLP Vía Augusta 185, 08021, Barcelona, Spain. 20. National Scoliosis Center, Fairfax, VA, USA. 21. Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA. 22. Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China. 23. Align Clinic, LLC and Align Technologies, LLC, San Mateo, CA, USA. 24. Boston Orthotics and Prosthetics, Boston, MA, USA. 25. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 26. Kuća Zdravlja D.O.O, Poljička 31, 10 000, Zagreb, Croatia. 27. Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 28. Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 29. Scoliosis and Spinal Disease Center, Hesperia Hospital GHC SPA, Modena, Italy. 30. Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA. 31. Scoliosis Physiotherapy and Posture Centre Ottawa, Ottawa, ON, Canada. 32. H. Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery, Saint-Petersburg, Russia. 33. Rady Children's Hospital, University of California, San Diego, USA. 34. Texas Children's Hospital, Professor of Orthopaedics, Baylor College of Medicine, Houston, TX, USA.
Abstract
PURPOSE: Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types. METHODS: Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies' officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM. RESULTS: The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction-valves (monocot, bivalve, multisegmented), construction-closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups. CONCLUSION: The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.
PURPOSE: Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types. METHODS: Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies' officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM. RESULTS: The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction-valves (monocot, bivalve, multisegmented), construction-closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups. CONCLUSION: The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.
Authors: Matthew E Simhon; Michael W Fields; Kelly E Grimes; Prachi Bakarania; Hiroko Matsumoto; Afrain Z Boby; Hagit Berdishevsky; Benjamin D Roye; David P Roye; Michael G Vitale Journal: Spine Deform Date: 2020-11-23
Authors: Stefano Negrini; Fabrizio Tessadri; Francesco Negrini; Marta Tavernaro; Andrea Zonta; Fabio Zaina; Sabrina Donzelli Journal: Children (Basel) Date: 2022-06-11
Authors: Patrick Strube; Chris Lindemann; Max Bahrke; Steffen Brodt; André Sachse; Lya I Reich; Alexander Hoelzl; Timo K Zippelius Journal: Children (Basel) Date: 2022-05-03