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Double-Shelled Brace to Correct Spinal Deformity in Non-Ambulatory Patients with Cerebral Palsy A STROBE-Compliant Study

Author(s): Adrian Bosshard, Maden Nadarajalingam, Sandra Keller, Reinald Brunner, Carlo Camathias, Erich Rutz

Introduction: The generally accepted incidence of scoliosis in cerebral palsy (CP) is 20% to 25% and is directly related to the Gross Motor Function Classification System (GMFCS) level. One treatment option for neurogenic scoliosis is a double-shelled brace (DSB). The aim of this study was to investigate the degree of correction achieved when using three different replica techniques. 

Materials and Methods: We included a consecutive series of 25 CP patients (8 boys, 15 girls) in this retrospective study. Mean age was 13.0 years (range: 4.0 to 20.0 years). All participants were non-ambulatory (GMFCS levels IV and V). The degree of immediate correction was expressed in percent of the lumbar and thoracic COBB angles. 

Results: At the level of the lumbar spine, we found a mean (± SD) curve of 45.7° (19.2°). Mean correction with the DSB was 20.9° (13.1°; p<0.05). This represents an improvement of 49.9% At the level of the thoracic spine, we determined a mean curve of 40.5° (17.8°). In all the cases, we measured the immediate correction. Mean correction with the DSB was 13.8° (10.3°; p<0.05). This represents an improvement of 33.1%. All three replica techniques achieved a statistically significant correction (p<0.05) of the COBB angles at both levels. 

Conclusions: Double-shelled bracing provides an excellent immediate correction of neurogenic scoliosis in cerebral palsy. Further studies are required to investigate long-term outcomes.

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