Brace Technology Thematic Series - The Sforzesco and Sibilla Braces, and the SPoRT (Symmetric, Patient Oriented, Rigid, Three-dimensional, Active) Concept

Overview

Journal Scoliosis

Publisher Biomed Central

Date 2011 May 11

PMID 21554719

Citations 27

Authors

Stefano Negrini

Gianfranco Marchini

Fabrizio Tessadri

Affiliations

Soon will be listed here.

Abstract

Background: Bracing is an effective strategy for scoliosis treatment, but there is no consensus on the best type of brace, nor on the way in which it should act on the spine to achieve good correction. The aim of this paper is to present the family of SPoRT (Symmetric, Patient-oriented, Rigid, Three-dimensional, active) braces: Sforzesco (the first introduced), Sibilla and Lapadula.

Methods: The Sforzesco brace was developed following specific principles of correction. Due to its overall symmetry, the brace provides space over pathological depressions and pushes over elevations. Correction is reached through construction of the envelope, pushes, escapes, stops, and drivers. The real novelty is the drivers, introduced for the first time with the Sforzesco brace; they allow to achieve the main action of the brace: a three-dimensional elongation pushing the spine in a down-up direction.Brace prescription is made plane by plane: frontal (on the "slopes", another novelty of this concept, i.e. the laterally flexed sections of the spine), horizontal, and sagittal. The brace is built modelling the trunk shape obtained either by a plaster cast mould or by CAD-CAM construction. Brace checking is essential, since SPoRT braces are adjustable and customisable according to each individual curve pattern.Treatment time and duration is individually tailored (18-23 hours per day until Risser 3, then gradual reduction). SEAS (Scientific Exercises Approach to Scoliosis) exercises are a key factor to achieve success.

Results: The Sforzesco brace has shown to be more effective than the Lyon brace (matched case/control), equally effective as the Risser plaster cast (prospective cohort with retrospective controls), more effective than the Risser cast + Lyon brace in treating curves over 45 degrees Cobb (prospective cohort), and is able to improve aesthetic appearance (prospective cohort).

Conclusions: The SPoRT concept of bracing (three-dimensional elongation pushing in a down-up direction) is different from the other corrective systems: 3-point, traction, postural, and movement-based. The Sforzesco brace, being comparable to casting, may be the best brace for the worst cases.

Citing Articles

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort.

Negrini F, Febbo F, Tessadri F, Zonta A, Tavernaro M, Donzelli S J Clin Med. 2024; 13(7).

PMID: 38610839 PMC: 11012574. DOI: 10.3390/jcm13072075.

Spinal Orthosis in Adolescent Idiopathic Scoliosis: An Overview of the Braces Provided by the National Health Service in Italy.

Del Prete C, Tarantino D, Viva M, Murgia M, Vergati D, Barassi G Medicina (Kaunas). 2024; 60(1).

PMID: 38276037 PMC: 10818494. DOI: 10.3390/medicina60010003.

Personal and Clinical Determinants of Brace-Wearing Time in Adolescents with Idiopathic Scoliosis.

Fregna G, Rossi Raccagni S, Negrini A, Zaina F, Negrini S Sensors (Basel). 2024; 24(1).

PMID: 38202978 PMC: 10780905. DOI: 10.3390/s24010116.

Cross-cultural validation of the Italian Spine Youth Quality of Life questionnaire: the ISYQOL international.

Negrini S, Zaina F, Buyukaslan A, Fortin C, Karavidas N, Kotwicki T Eur J Phys Rehabil Med. 2023; 59(3):364-376.

PMID: 37195649 PMC: 10272934. DOI: 10.23736/S1973-9087.23.07586-X.

Predictors of Clinically Meaningful Results of Bracing in a Large Cohort of Adolescents with Idiopathic Scoliosis Reaching the End of Conservative Treatment.

Donzelli S, Fregna G, Zaina F, Livetti G, Reitano M, Negrini S Children (Basel). 2023; 10(4).

PMID: 37189968 PMC: 10136690. DOI: 10.3390/children10040719.

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