The Boston Brace RC is an asymmetrical, anterior opening, custom fabricated scoliosis orthosis. This is a custom made brace from a scan of the patient and incorporates the principles of the Rigo-Cheneau brace.
Defining the Spinal Curve
The Boston Brace RC provides a systematic approach with the specific design of the orthosis guided by a classification system. This classification includes clinical and X-ray criteria.
The clinical criteria are used to describe four basic spinal curve types: Type A – imbalanced thoracic; Type B – true double curve; Type C – balances thoracic and false double; and Type E – single lumbar or thoracolumbar.
The X-ray is then used to further refine the specific curve characteristics into nine sub-types.
Three-Point Pressure System
The biomechanical principles include a three point pressure system in all planes. Lumbar and thoracic forces are incorporated into the design and are enhanced at times with additional pads. Vectors are located at the apex of the curve on the convex side providing a resultant oblique force in a dorso-lateral to ventro-medial direction. Counter forces are built into the model with void areas to allow movement.
Emphasis is on the de-rotational aspect of curve correction. The sagittal profile is preserved and the posterior superior trim line is designed to help prevent the morphological thoracic flat back.
This orthosis is custom made from a scan of the patient and it is modified in computer aided design, or CAD. The classification system is crucial to the repeatability of this system.