Bracing Adult Scoliosis: From Immobilization to Correction of Adult Scoliosis

Unlike adolescent idiopathic scoliosis, bracing was used in adults less and was used more as a way of reducing pain. There is little publication of adult scoliosis series in the literature. The use of very high-rigidity and high-precision CAD/CAM technologies currently makes it possible to create corrective braces for the adult. The digital CAD/CAM cast in three blocks allows for precise correction at the pelvic, lumbar, and thoracic levels. This chapter presents the results of a series of 62 consecutive adult scoliotic patients treated with a corrective asymmetric detorsion brace of very high rigidity made in 2014–2016. Tolerance and angular correction results will be compared to those of 158 patients treated with the former bivalve polyethylene overlapping immobilization brace mainly used for lumbar scoliosis. The new Lyon adult ARTbrace is a detorsion brace adapted to all the curvatures which controls the sagittal plane. Despite a resistance four times greater than that of polyethylene of the same thickness, the tolerance of the Europlex’O is excellent as it is a “shock absorber,” and the anterior opening facilitates the use for very old people. Consequently, the aim of this chapter is to consider if it is possible to envisage for some patients an alternative to surgery, thanks to the new technologies of bracing