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Adolescent Idiopathic Scoliosis

Cheneau Type Brace Using the Rigo Classification of Scoliosis and Brace Design with the WCR Brace


The purpose of the SOSORT 2014 brace contest is to share with scoliosis professionals how different scoliosis brace techniques are utilized and applied to treat the same patient with idiopathic scoliosis (IS). The purpose of this poster is to present to scoliosis professionals how a specific technique is utilized to treat a patient with IS.

Case Presentation

This brace contest entry reviewed the case of a 10-year-old girl diagnosed with IS (Figure 1). The patient presented with a right low thoracic curve of 40 degrees Cobb angle (Figure 2). The apex of the right curve was at T11, and therefore would be a thoracic curve according to the SRS. The upper end plate of the thoracic curve did not extend as high as a typical A type scoliosis case. The A1 type brace was fabricated with the left axilla pad being lower than usual due to the short thoracic curve. The right thoracic pad was placed lower than usual and started applying pressure below the T11 apex and going upward to above the apex. The E2 type brace was considered, but the classification criteria better fit the A1 type scoliosis according to the Rigo classification of scoliosis, since the apex was at T11. (Rigo M, Villagrasa M, Gallo D, 2010, see Figure 3).

The author classified, designed and fabricated a hand-made Cheneau-type brace using an A1 model following the Rigo classification of scoliosis (Figure 4). The brace design was determined by the x-rays and clinical photos only. No physical examination was performed by the author. The brace was fabricated from a scan of the patient which was carved with a Rodin carver, and subsequently hand-modified by the author.


The differences between the original Cheneau brace and the author’s Cheneau-Rigo handmade type brace are the following:

  1. The brace was designed using the Rigo Classification of scoliosis and brace design. by Manuel Rigo
  2. The new Cheneau brace follows the current design shapes taught by Manuel Rigo, MD. Thus, it is a Cheneau-Rigo handmade type brace
  3. The brace was handmade by the author and it is the author’s personal version of the Cheneau-Rigo brace, thus the name follows the evolution of the brace, Wood Cheneau Rigo (WCR) brace (Figure 5).

Brace Design and Function

The general correction principle is detorsion and sagittal normalization. This effectively corrects the coronal plane, resulting in some elongation of the spine without any significant distraction forces. (Dubousset J, 1992; Cheneau J, 1996).

The A1 type WCR brace was fabricated (Figure 5). The derotation forces in the transverse plane are demonstrated in a WCR brace in Figure 6. Sagittal plane normalization and derotation are achieved by elongation of the spine as well as the ventral and dorsal pressure systems, as demonstrated in an A1 type scoliosis brace in Figure 7.

Discussion and Conclusion

It is the author’s opinion that this Cheneau type brace would provide optimal 3D correction of the scoliosis, acceptable in-brace correction and improvement of the patient’s clinical presentation (in-and out of the brace). There is a high risk of progression, thus close follow-up of this patient is critical, especially during the start of puberty.


a. Patient pre-brace 
b. During first bracing treatment, out-of-brace for 24 hours 
c. Patient in first brace 
d. Patient in second brace and taking Schroth Therapy from Hagit Berdishevsky, DPT
e. Patient during second bracing treatment, still taking Schroth from Hagit Berdishevsky, DPT


WCR Brace. C2 type brace using the Rigo Classification of scoliosis.​Patient presented with a non-three non-four curve pattern measuring 16°, 30°, and 25° as seen about and was reduced to 12°, 7°, and 1° respectively. Patient maintaned strong correction out-of-brace as seen in the X-rays above.


a. Patient’s Sagittal plane pre-bracing (high degree of lordosis)

b. Patient in a WCR Brace (lordosis within normal range)


a. Pre-brace
b. In-brace, after first fitting ​
c. Out-of-brace after 4 months

Out-of-brace Before 3rd WCR

3rd WCR Brace

Post treatment 32 months of bracing

Clinical presentation ​post-treatment

19 months post-bracing

31 months post-bracing

a: Pre-brace 
b: In-brace, after first fitting 
c: Out-of-brace after 4 months
d: After 12 months, out-of-brace for 8 hours
e. End of growth after 28 months of bracing, out-of-brace for 24 hours 
f. End of growth after 28 months of bracing, out-of-brace for 6 months
g. End of growth after 28 months of bracing, out-of-brace for 19 months
h. End of growth after 28 months of bracing, out-of-brace for 31 months


a. Pre-brace
b. In-brace after first fitting
​c. Out-of-brace for 24 hours, 5 months after first fitting
d. Patient in first brace, modified for growth
e. After 13 months of treatment, 24 hours out-of-brace
​f. Patient in second brace after initial fitting


a: Patient pre-brace.
b: Patient 10 months after WCR brace
c: Patient 43 months after WCR brace

a: Pre-brace
b: In-brace after first fitting 
c: 4 months after wearing WCR brace, out of brace for 24 hours
d: 2nd WCR, after 10 months in previous brace 
e: 17 months after wearing WCR brace, out of brace for 24 hours 
f: 43 Months after wearing WCR Brace, out of brace for 24 hours


a: Pre-WCR
b: Patient in 2nd WCR
​c: In-brace X-ray after 9 months of bracing

d: Patient in 3rd WCR brace
e: X-ray in 3rd WCR after 17 months
​f: Out-of-brace after 20 months. End of bracing due to skeletal maturity.


a. Pre-brace
b. In WCR Brace with X-ray composite ​
c. After 18 months in brace, out-of-brace for 24 hours


a: Pre-brace​
b: X-ray composite, 1 month in a WCR brace
​c: 4 months of wearing a WCR, 24 hours out-of-brace
​​d: X-ray composite, 18 months in WCR braces


Patient practicing Schroth Therapy with Jeanann Maguffin of Scoliosis Care Physical Therapy in New York since March 2014
a: Pre-brace 
b: In-brace after first fitting
c​: In-brace with D modifier after 3 months 
d: After 3 months in a WCR, 24 hours out-of-brace
e​: After 10 months, 24 hours out-of-brace