A spinal orthosis fabricated from prestressed carbon and polyethelene was reported to have high rates of compliance as it partly maintained spine and chest mobility and improved respiratory capacity, according to a study recently published in Scoliosis.

With scoliosis detection occurring earlier in patients, doctors at Massues Center Hospital in Lyon, France wanted to develop an orthosis that would be comfortable and effective without impeding development.

“Braces should have minimal impact on these young children’s lives, while remaining effective on curve corrections,” the authors wrote in the study. “Braces have to take into account new needs, such as comfort, lightness, aesthetics, preservation of respiratory capacity and overall respect for the child’s growth.”

The Carbone brace

The Corset Monocoque Carbone respectant la Respiration (CMCR) brace, which translates to “Monoshell Carbon Brace respecting breathing,” was inspired by the design of the Lyon brace.

“Currently available braces have demonstrated a real efficiency but still present disadvantages because of their rigidity, especially for the thoracic function that is limited by the lack of expansion while breathing in,” the authors wrote.

The CMCR brace, intended for the treatment of progressive thoracic, thoraco-lumbar or combined scoliosis, utilizes the Lyon brace support concept, except the rigid supports are replaced with prestressed carbon brace braids that connect adjustable pads to the polyethylene main shell.

“It calls upon new materials that are more efficient, but also more comfortable,” the authors wrote. “Thus, results on scoliosis curves remain optimal without interfering with thoracic growth and rely on a greater participation of the child, which is the key to the treatment success.”

Clinical studies

Study results were presented in two published articles. The first was a retrospective analysis of 115 patients, which appeared in the French-published Annals of Physical Medicine and Rehabilitation in 2005. The article reported that the CMCR brace stabilized moderate scoliosis, decreased the vital [respiratory] capacity (VC) of 13% of the patients compared with the VC of patients who did not use the brace and did not have significant impact on hump reduction. The researchers also found that treatment was more effective if it was started when the patient’s Risser score was before 3.

The brace was modified to increase the dorsal pad pressure and 3-D analysis more precisely defined the location of correction forces, the authors wrote.

A second study was then conducted and published in Scoliosis in 2011. This study included 90 patients and focused on how the brace affected VC. They found that VC increased by 21% from the theoretical measurement at definitive brace removal. The researchers also noted that compliance was high for patients using the CMCR brace.

“The difference between the time where the child actually wears the brace and the time asked by the clinician for the brace to be worn was only 1 hour, which means that the brace is accepted by teenagers,” the authors wrote in the study.

According to the authors, the CMCR brace is innovative in its use of prestressed carbon to correct deformities while increasing chest movement and preserving respiratory capacity. The application of mobile supports can also be adjusted as the patient develops. “This support keeps some mobility during movements, and especially in respiratory ones,” the authors noted.

And because of the flexible material, treatment with the CMCR orthosis can be started at a younger age than more traditional spinal orthoses.

“This orthosis is designed to partly preserve spine and chest mobility,” the authors wrote. “We hope to be a part of improving life conditions for these teenagers.” — by Megan Gilbride

For more information:
Bernard JC. Scoliosis. 2013 Feb 14;8(1):3. [Epub ahead of print]

Disclosure: The authors have no relevant financial disclosures.

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