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    Corse Cheneau

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    iguija6769
    This document presents a new classification system for differentiating between scoliosis deformity patterns to facilitate appropriate brace selection for treatment. The classification system divides deformities into 4 main categories based on primary and secondary curve location. A study of 1700 patients validated the classification by assessing interobserver agreement on brace type selection using the new system, finding good agreement between physicians (Cohen's kappa 0.89) and physicians and orthotists (Cohen's kappa 0.82 and 0.81). The classification aims to standardize brace choice according to deformity pattern for improved clinical outcomes.

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    Corse Cheneau

    Uploaded by

    iguija6769
    84 views17 pages
    This document presents a new classification system for differentiating between scoliosis deformity patterns to facilitate appropriate brace selection for treatment. The classification system divides deformities into 4 main categories based on primary and secondary curve location. A study of 1700 patients validated the classification by assessing interobserver agreement on brace type selection using the new system, finding good agreement between physicians (Cohen's kappa 0.89) and physicians and orthotists (Cohen's kappa 0.82 and 0.81). The classification aims to standardize brace choice according to deformity pattern for improved clinical outcomes.

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    This document presents a new classification system for differentiating between scoliosis deformity patterns to facilitate appropriate brace selection for treatment. The classification system divides deformities into 4 main categories based on primary and secondary curve location. A study of 1700 patients validated the classification by assessing interobserver agreement on brace type selection using the new system, finding good agreement between physicians (Cohen's kappa 0.89) and physicians and orthotists (Cohen's kappa 0.82 and 0.81). The classification aims to standardize brace choice according to deformity pattern for improved clinical outcomes.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    84 views17 pages

    Corse Cheneau

    Uploaded by

    iguija6769
    This document presents a new classification system for differentiating between scoliosis deformity patterns to facilitate appropriate brace selection for treatment. The classification system divides deformities into 4 main categories based on primary and secondary curve location. A study of 1700 patients validated the classification by assessing interobserver agreement on brace type selection using the new system, finding good agreement between physicians (Cohen's kappa 0.89) and physicians and orthotists (Cohen's kappa 0.82 and 0.81). The classification aims to standardize brace choice according to deformity pattern for improved clinical outcomes.

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    of 17

    Differentiated approach to Cheneau brace choice for the soliosis treatment

    D. Chekryzhev, MD A. Mezentsev, MD D. Petrenko, MD -Orthospine Ltd, -Sytenko Institute of Spine and Joint Pathology Kharkov

    Background
    The vast majority of the scoliosis classifications are directed at the diagnosis and surgical treatment; Selection of the appropriate brace according to the deformity pattern is still a problem for some MDs and technicians; Development of the new easy in use clinical classification for the scoliosis for a brace treatment should facilitate better clinical results

    Object of the investigation

    To validate choice of the Cheneau brace according to scoliotic deformity type

    Material and methods


    1700 AIS patients major deformity Cobb angle ranged 20-40 spinal rotation ranged 15-35 age of the patients was ranged 11-15 years old standard radiological measurements and clinical presentation of the deformity Inclusive criteria were: AIS pts, skeletal immaturity, pts treated with Cheneau brace Interobserver agreement was assessed using Cohen's kappa coefficient

    A specific scoliosis classification for Cheneau brace treatment


    1.Primary thoracic and secondary lumbar/thoracolumbar curve 1.1 primary thoracic and secondary lumbar/thoracolumbar curve. The apex of lumbar/thoracolumbar curve is L1 or L1-2 or L2. 1.2 primary thoracic and secondary lumbar curve. The apex of lumbar curve is L2-3 or L3. 1.2.1 primary thoracic and secondary lumbar curve. The apex of lumbar curve is L3. The counter-tilting of L5-4-3 is horizontal. 1.3 primary thoracic and secondary lumber curve. The apex of lumbar deformation is L4-L5 2.Primary thoracolumbar and secondary lumbar curve 3.Primary lumbar curve with/without secondary thoracic curve 3.1 primary lumbar curve , the apex of deformation is L1-2 or L2 3.2 primary lumbar curve with secondary thoracic curve , the apex of lumbar deformation is L1-2 or L2. 3.3 primary lumbar curve , the apex of deformation is L2-3 or L3 3.4 primary lumbar curve with secondary thoracic curve , the apex of lumbar deformation is L2-3 or L3. 4. Triple curve deformation

    Types of braces depending spine deformation feature

    A (A1, A2, A3) braces for thoracic or thoracolumbar deformations (primary or secondary) B (B1, B2) braces for lumbar deformations without secondary thoracic deformations C braces for triple curve deformations

    1.Primary thoracic and secondary lumbar/thoracolumbar curve

    1.1 - A1
    Pelvis translation Trunk imbalance Thoracic rib hump Lumbar hump TP T1 L4-L5 Convex Concave/balanced + + Concave Concave +

    1.2 A2
    Convex Concave/balanced + + CSL Concave -/+

    1.2.1 A3
    Concave/centred Convex + Convex Convex Horizontal with L3

    1.3 A3
    Concave/centred Convex + Convex Convex Horizontal

    2.Primary thoracolumbar and secondary lumbar curve

    Pelvis translated Trunk imbalance Thoracic rib hump Lumbar prominence TP T1 L4-L5

    concave convex + convex convex horizontal

    3.Primary lumbar curve with/without secondary thoracic curve

    3.1 B1
    Pelvis translation Trunk imbalance Thoracic rib hump Lumbar hump TP T1 L4-L5 Concave lumbar side Concave lumbar side + Convex lumbar side Convex lumbar side +

    3.2 A1
    Concave lumbar side Balanced + + CSL CSL +

    3.3 B2

    3.4 A2

    Concave lumbar side Concave lumbar side Concave lumbar side Balanced + + + Convex lumbar side CSL Convex lumbar side CSL -

    4. Triple curve deformation

    Triple curve deformation has a three structural curve. The brace of this type has a cervical lateral pressure zone.

    Brace patterns

    Reliability study
    (Cohen's kappa coefficient)
    Independent observers: two medical doctors (MD1 and MD2) and one orthotist (Orth) 68 AP radiographs of AIS pts were studied. Cohen's kappa coefficient values was calculated three time.

    Cohen's kappa coefficient


    MD1:MD2 - 0,89
    1.1 1.1 1.2 1.2.1 1.3 2 3.1 3.3 4 13 0 0 0 0 1 0 0 14/68 1.2 1 10 1 0 0 0 1 0 13/68 1.2.1 0 0 7 2 0 0 0 0 9/68 1.3 0 0 0 7 0 0 0 0 7/68 2 0 0 0 0 12 0 0 0 12/68 3.1 0 0 0 0 0 9 0 0 9/68 3.3 0 0 0 0 0 0 1 0 1/68 4 0 0 0 0 0 0 0 3 3/68 14/68 10/68 8/68 9/68 12/68 10/68 2/68 3/68

    Cohen's kappa coefficient


    MD1:Orth 0,82
    1.1 1.1 1.2 1.2.1 1.3 2 3.1 3.3 4 13 2 0 0 0 1 0 1 16/68 1.2 1 8 0 0 0 1 0 0 10/68 1.2.1 0 0 7 1 0 0 0 0 8/68 1.3 0 0 1 8 2 0 0 0 10/68 2 0 0 0 0 10 0 0 0 10/68 3.1 0 0 0 0 0 8 0 0 8/68 3.3 0 0 0 0 0 0 2 0 2/68 4 0 0 0 0 0 0 0 2 2/68 14/68 10/68 8/68 9/68 12/68 10/68 2/68 3/68

    Cohen's kappa coefficient


    MD2:Orth 0,81
    1.1 1.1 1.2 1.2.1 1.3 2 3.1 3.3 4 12 2 0 0 0 1 0 0 15/68 1.2 2 7 0 0 0 0 0 1 10/68 1.2.1 0 1 7 0 1 0 0 0 9/68 1.3 0 0 1 8 1 0 0 0 10/68 2 0 0 0 1 10 0 0 0 11/68 3.1 0 0 0 0 0 9 0 0 9/68 3.3 0 0 0 0 0 0 2 0 2/68 4 0 0 0 0 0 0 0 2 2/68 14/68 10/68 8/68 9/68 12/68 10/68 2/68 3/68

    Conclusion

    Scoliosis deformity classification provides differentiated Cheneau brace selection according to the deformity pattern with good interobesrver agreement

    THANK YOU

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