The Chêneau concept of bracing--biomechanical aspects

Current concept of bracing must take in consideration both the three-dimensional (3D) nature of Adolescent Idiopathic Scoliosis (AIS) and its pathomechanism of progression. A modern brace should be able to correct in 3D in order to break the so called 'vicious cycle' model. Generally speaking, it is necessary to create detorsional forces to derotate in the transversal plane, to correct the lateral deviation in the frontal plane and to normalize the sagittal profile of the spine. Breathing mechanics can be used to fight against the thoracic structural flat back. The original Chêneau brace was introduced at the end of the 70's and its principles were based more in anatomical observations rather than in biomechanics. A further evolution , enunciating new principles, has allowed a higher standard, improving in brace corrections and trunk modelling. This biomechanical principles have been developed under the name of Rigo-Chêneau-System (RSC) and used later in latest brace models like the Chêneau light with reduced material, and similar in brace corrections. Experience is also important to improve the end results. The blueprints to built the brace according to the anatomorradiological pattern are very helpful.