Orthosis component for the Ortholutions Original RSC® Brace

There are several technical and therapeutic approaches to dealing with high thoracic or so-called double / triple major curvatures. Some experts even pay no attention to the special circumstances.

Figure: High thoracic scoliosis in the Original Rigo® System Cheneau® RSC® Brace by Ortholutions, The D-modifier component acts according to the specific physiotherapy (BSPTS) in scoliosis patients.
Figure: Scoliosis – biomechanics and lever, the three-point principle for correcting a thoracic scolistic curvature

High-thoracic scoliosis (or double / triple-major scoliosis) poses a technical challenge for orthopedic technicians to construct the orthosis for treatment in such a way that the shoulder/neck area, in which the curvature is represented, can align itself in the body plumb bole.

Figure: The vertex vertebra is located between the second and sixth thoracic vertebrae according to the Lenke classification (Th 2 and Th 6).

Treat high thoracic scoliosis with Original RSC® Brace

Dr. Lawrence G. Lenke is a leading expert in complex spinal deformity surgery. In 2001 he published his detailed and in comparison to the King classification more complex classification of idiopathic scolioses.

The Ortholutions Original RSC® Brace Scoliosis Corset has certain biomechanical designs to create a fulcrum via a so-called hypomochlion (pivot point to aid or induce leverage) that allows it to elevate beyond the vertex of the upper curve to the body plumb line.

Basically, so-called three-point systems are always installed in a torso orthosis for correction in the frontal plane.

The third point required for correction with high thoracic bends would be in the neck or head area of ​​the patient to function as a fulcrum. Technically, a solution can usually be found in these cases.

However, the implementation entails great cosmetic restrictions for the corset wearers, since the parts required for correction usually act via belt systems in the neck area. As a rule, such constructions are not used, since the mental stress of the patient is not related to the expected result.

A hypomochlion is a pivot point to support or leverage, the biomechanical design is specifically integrated into the Ortholutions Original RSC® Brace trunk orthosis.

A new approach to correcting the high thoracic curvature of scoliosis with an accessory component on the corset has its origins in physiotherapy.

Figure: The BSPTS (Barcelona Scoliosis Physical Therapy School) developed by Dr. Manuel Rigo MD based on the proven Schroth therapy.

Derived from physiotherapeutic exercises, the D-modifier component was developed. D-Modifier comes from the terminology of the scoliosis classification developed by Rigo and is added to the four basic types when a high-thoracic curvature can develop or is already manifested in scoliosis.

The D-modifier component creates compression on the high thoracic apex (rib hump) and, associated with this, produces a horizontal translation of the head to the body center. This is generated by a specially attached to the D-modifier belt.

The biomechanical effect is carefully checked by the orthopedic technician. If the D-modifier component is misplaced, the effect may be absent as with physiotherapy exercises – or, more likely, it may even negatively impact the situation.

Abgeleitet von physiotherapeutischen Übungen wurde die D-modifier-Komponente entwickelt. D-Modifier stammt aus der Terminologie der von Rigo entwickelten Skoliose-Klassifizierung und wird als Zusatz zu den vier Grundtypen hinzugefügt, wenn sich bei einer Skoliose eine hochthorakale Krümmung entwickeln kann oder schon manifestiert ist.

Die D-modifier-Komponente erzeugt Kompression auf dem hochthorakalen Apex (Rippenbuckel) und damit einhergehend wird eine horizontale Verschiebung (Translation) des Kopfes zur Körpermitte erzeugt. Diese wird über einen am D-Modifier speziell befestigten Gurt erzeugt.

Die biomechanische Wirkung wird vom Orthopädietechniker genauestens geprüft. Wird die D-modifier-Komponente falsch umgesetzt, kann der Effekt ebenso wie bei den physiotherapeutischen Übungen ausbleiben – oder aber, was wahrscheinlicher ist, die Situation sogar negativ beeinflussen.

Figure: D-modifier TLSO hull orthosis component before mounting to the Ortholutions Original RSC® Brace

Check before the first fitting of the corset

The D-modifier component is applied at night or at home, to save the scoliosis patient in everyday life the cosmetic disadvantage.

Compared to the conventional belt constructions, the new approach shows a significantly improved implementation of the required correction forces and the associated  biomechanical effect.

The new D-modifier component has proved to be a useful supplement for horseshoe orthoses for the correction of high-thoracic scoliosis. Since the component is individually adaptable, the social life is less negatively influenced.

The compliance and thus the wearing times of the trunk orthoses are thus increased, which leads to a better overall result.