The RSC® brace. 

Progress of an original RSC brace Rigo Cheneau scoliosis brace treatment

The name of an orthotic construction does not represent a particular standard.

In practice it is often seen that patients are given malfunctioning orthotic constructions of well-known brands, and that these are paid for by health insurance providers without any adequate checking.

In spite of a lot of information possibilities, many patients and their families are still left completely on their own with the diagnosis and therapy.

Although it is nowadays known how important it is to provide adequate information and a solid treatment concept for scoliosis therapy.

The number of patients presenting with huge cosmetic and psychological problems due to large curvatures and all the resulting pathological mechanisms at the end of the growth phase could be significantly smaller if a correct and above all timely diagnosis were made and  comprehensive support given to all occupational groups involved.

What means are there for non-specialized doctors, therapists and orthopaedic technicians to change anything here? What possibilities would open up if the occupational groups involved in the therapy would specialize more, and fall back on tried and tested holistic systems of treatment?

RSC® Management System

The RSC®  Mnagement System is a patented method producing computer standardized and at the same time individually fitted trunk orthoses for scoliosis  patients. On the basis of the patient’s measurements, the system establishes an exact CAD CAM reproduction of an original Rigo brace.

The biomechanical design of every specific curvature model is retained to one hundred per cent. For this, the expert’s original self-designed positive brace models are digitalised for the Ortholutions model data bank by means of a special process. For the production of a brace, measurements and photographs specific to the patient are necessary in order to guarantee an orthosis which is individual for each patient.

A comprehensive three-day RSC®  workshop is held to teach the management philosophy as well as the theoretical and practical skills required for setting up the specific data and for the expert fitting of the orthoses. Patient data is uploaded for this via the Internet on to a secure data bank. Each team has its own secure account.

The data bank as a central platform for communication is the pivotal point for the treatment team. It is also guaranteed here that an individual diagnosis is made by Dr. Rigo for every patient receiving a RSC®  brace. The diagnosis also includes the scoliosis expert’s own model specification of what is required for the patient’s individual type of curvature(curvature classification according to Rigo).

Brace modules that are ready to be fitted are sent to the RSC®  treatment centres and fitted on the spot by trained teams. Fitting, handing over and monitoring of the clinical course are always documented photographically and stored in the data bank. Complications and complex questions can also be discussed and clarified here at any time with the team of experts and/or Dr. Rigo.

Information and solutions to problems are passed on in a swift and straightforward way. Through the communication platform, the system in this way guarantees trained teams and maximum treatment safety through constant further development in know-how. The complete RSC®  package guarantees safety, because it is obligatory that only trained experts familiar with the technology and philosophy of the management are involved. The trunk orthoses are delivered only to certified treatment centres or are fitted by the manufacturer himself.

The brace treatment system is integrated into an internationally established physiotherapy programme, the BSRS Barcelona Scoliosis Rehabilitation School concept, which was developed by Dr. Rigo and is based on the teaching of Katharina Schroth and Christa Lehnert-Schroth. This method also includes modifications from the French school (6).

Case history of a course of treatment over a time of 32 months

At least four digital photos (4 clinical views) are generally required for the clinical documentation (taking measurements, fitting, clinical monitoring appointments). These are taken in the LASAR posture (manufacturer: Otto Bock).

On the basis of compression measuring plates the LASAR posture determines the exact centre of gravity of the body and projects the actual line of the gravity on to the patient with the help of a red laser beam. In this way the important aid enables precise conclusions to be drawn from the actual statics of the initial situation.

Fig. 1

rsc brace rigo cheneau scoliosis treatment in cad cam

Fig. 1
X-rays are showing a three curve type A scoliosis well corrected in the RSC brace

A female patient with a triple curvature, group A2 according to the Rigo classification. The Cobb angle of the main thoraco-lumbar curvature is 49°.

The asymmetry of the trunk through the collapse on the concave side of the thoracic curvature as well as the hump of the ribs on the opposite side can be clearly seen clinically.

The left shoulder is consequently lowered. From the CSL (central sacral line – a vertical line from the centre of the sacrum) the overhang to the right or the prominence of the pelvis on the left can be seen.

The concave collapse is corrected in the brace. To achieve this, a three point system is necessary on the frontal plane, producing the so-called mirror effect. The patient is overcorrected through the orthosis and straightened up, and the hump of the ribs is reduced. In order to open the collapsed thoracic concave side and to establish the three dimensional correctional mechanism, the shoulder of the thoracic concave side in type A2 curvatures (triple curvature) needs to be raised by the brace construction.

The main thoracic curvature is corrected in the brace to a Cobb angle of 24°. The X-ray of the position in the brace shows that the ribs on the concave thoracic side are distinctly more “opened” than beforehand, and the CSL shows that the overhang to the right has been eliminated through the brace.


Fig. 2

rsc brace scoliosis patient in non tree non four brace well corrected

Fig. 2 – Change of the curve Type, new RSC brace model is a C type non tree non four orthosis module

Clinical picture of the patient 8 months later: the symmetry of the trunk is greatly improved.

As a result of this the collapse of the thoracic concave side is significantly reduced and the shoulder position is normal.

The Cobb angle of curvature is 35° without the brace. The X-ray shows  an improved and thus corrected position of the ribs in the concave area of the thoracic curvature.

The pattern of curvature has altered, and for this reason orthotic treatment is continued with a RSC® module for a Rigo type C1 curvature.

Because of the altered situation, the correctional principles do not require displacement of the pelvis, instead a central stabilisation can be seen. In comparison with the preceding A2 brace module, the left shoulder is not raised so much. An observation the line of gravity, also on the X-ray, shows a slight decompensation to the left, caused by the varying stiffness of the curvatures and the correctional pressure of the orthosis. The main curvature is corrected to an 18° Cobb angle in the RSC®  brace.

Fig. 3

rsc rigo cheneau brace is correcting well scoliosis trunk asymmetry

Fig. 3

Both the clinical picture and the X-ray findings show a stable condition after a further 7 months. The body statics are almost in equilibrium.

The Cobb angle of curvature is 37° without the orthosis. The patient continues treatment with a type C1 brace module.

As can be seen by the picture in the brace, the left axillary pad has again been raised somewhat in order to deflect the thoracic curvature more.

It can be seen clearly that the brace, through the three point system in the frontal plane (axillary pad, thoracic pad and lumbar pad), reduces the rib hump and produces the accompanying over-correcting postural deflection.


Fig. 4

tree curve scolisois type a after rigo well corrected in ortholutions rsc brace

Fig. 4

A slightly worsened clinical situation presents 12 months later.

The pelvis projects noticeably more on the left, likewise involving a more noticeable collapse of the thoracic concave side.

An observation of the shoulder girdle shows that the left shoulder has sunk down somewhat in comparison with Fig.3. The X-ray confirms the new situation.

With an unchanged Cobb angle, the curvature pattern correlates again with the situation at the beginning of treatment (Rigo A2 type triple curvature).

A RSC®  type A2 module corresponding to the curvature is constructed for the further orthotic management. The shift of the pelvis to the right and the deflection of the thoracic segment  produce the required postural overcorrection (mirror effect).

At the beginning of treatment the marked deformities of the vertebrae and ribs can be seen clearly on the X-ray. The progression of the structural deformity of the ribs and vertebra of the thoracic curvature has been corrected. The orthosis modules have neutralized the unbalanced axial forces acting on the vertebrae and in this way made it possible for the bony structures to grow more evenly.

Fig. 5/6

Fig. 5


correction of vertebra with rsc rigo cheneau brace from ortholutions

Fig. 6 – The x-ray shows a clearly corrected apical vertebra

X-rays views over a period of 32 months. The correction of the ribs and vertebrae is shown to be stable during the growth phase.

The reduced wedge shape of the vertebrae within the curvature, particularly that of the apex vertebra, is marked by lines parallel to the dorsal plates.

A paper on the correction of vertebral body deformities through RSC braces was presented in April 2008 at the SOSORT conference in Athens.


A group of patients n = 147 was divided into two subgroups. The aim was to determine the average correction value of the main curvatures through the use of a RSC®  brace, taking the following parameters into account: 

average angle of the main curvature, the number of male patients, dispersion of curvature types according to Rigo, contingent of over-corrections, number of previous brace treatments, contingent of Cobb angle  50°, average correction of main curvature, contingent of patients between 15 and 16 years old, as well as the average age. In the first subgroup patients with a Cobb angle of  50° were not taken into account. Patients fulfilling the specifications of the (7) SOSORT Restrictive Criteria (RC) were selected for the second subgroup.

Restrictive criteria: sex, female; age, at least 10 years old;  present clinical signs of puberty, S2 or P2 on the Tanner scale; diagnosis, idiopathic scoliosis; Cobb angle, minimum 25°, maximum35°; Risser, 0.

In an 11.56% contingent of male patients in the entire group, an average main curvature angle of 36.52% was determined. The correction of this was 47.39%, whereby 65.99% of the test persons had received previous orthotic treatment and 19.05% of the main group had a Cobb angle of 50°.

Overcorrection was achieved in 5.44%. The average age was 12.97 years, with a contingent of 25.85% patients between15 and 16 years old. There were 42 patients in the group of those with a Cobb angle of 50°.

An average value of 30.21% for the main curvature was determined here; the average age was 12.07 years. A 60.26% correction of the main curvature was achieved and there were confirmed overcorrections in 11.90%.

The group of those between 15 and 16 years old made up 23.81%. 25 patients with a Cobb average main curvature angle of 26.67% fell within the SOSORT evaluation criteria (RC). In 12% of overcorrections a correction value of 61.09% for the main curvatures was established. The mean age of the patients was 12.32 years.


The success in conservative IS therapy with a trunk orthosis is defined by consistent teamwork and high quality, system-produced trunk orthoses. Patients throughout Germany are meanwhile able to enjoy safe, documented treatment of the highest consistent standard through the RSC®  system treatment centres.

The newest and most functional models of the system, incorporating all the most up to date scientific findings, are always available to the teams and thus to the patients. In view of the fact that there is always a huge leeway of interpretation in how a trunk orthosis should be produced, frequently resulting in patients receiving inadequate or even contra-productive orthoses, a standardized, systematic concept of treatment is of vital importance.

Here health insurance providers – in their own interest, and also particularly in the interest of the patients – should consider what prerequisites manufacturers should fulfil.

Genuine interdisciplinary cooperation and holistic treatment concepts are imperative. A system has been developed for this which secures and promotes straightforward and swift communication and documentation. A clear definition of the realistic goal is extremely important before every IS treatment. All those involved must realise that a successful conservative scoliosis therapy is not only measured by the Cobb angle achieved at the end of the brace treatment.

It is much more important to ensure that all experts supply professional information and advice throughout the period of treatment. Here the fact that the RSC®  treatment system always trains teams consisting of doctors, physiotherapists and orthopaedic technicians shows its effectiveness. This is advantageous both for the teams – because motivation and constantly increasing expertise is established – and also for the patients, who develop confidence in the teams’ care and supervision.

Frequent changing of doctors and orthopaedic technicians is thus stopped, as well as preventing the uncertainty caused by a lack of trust and insufficient information. It should never happen that a patient is made to feel unsure by the differing views of experts involved in the therapy.

The RSC®  system ensures that all questions, inconsistencies and differences of opinions that arise in any member of the team are handled in an interdisciplinary way. The positive side effect for health insurance providers is that  frequent changes of doctor and orthopaedic technician caused by uncertainty and frustration are prevented. As a result of this there are fewer new prescriptions.

As has been shown, the holistic treatment system enables a systematic reaction to any situations that arise to be made at any time through the documented course of treatment. The comprehensive documentation of patient data serves as a control mechanism of the treatment goals and thus of the work of the teams and the entire management concept.

The evaluated data from the past 6 years shows steady development and improvement. In 2006 Dr. Rigo presented a study at the SOSORT meeting in Poznan which showed clearly that the CAD CAM-produced RSC®  braces achieved the same results as his hand-made ones.

The result shows clearly how new technologies in conjunction with  medical, physiotherapeutic and orthopaedic technical expertise can be systematically developed to holistic treatment strategies. Treatment success and treatment safety is guaranteed by the interdisciplinary coherence of the whole RSC®  treatment concept package.


Dino Gallo


Ing. Anton – Kathrein – Str. 2

83010 Rohrdorf Thansau




  1. Vertebral deformity corrected by bracing: retrospective selected case series of 10 scoliosis patients treated with a RSC Brace/Manuel Rigo, Monica Villagrasa and Gloria Quera-Salvá E. Salvá Institute. Barcelona, Spain from 5th International Conference on Conservative Management of Spinal Deformities Scoliosis 2009, 4(Suppl 1):O45doi:10.1186/1748-7161-4-S1-O45/ The electronic version of this abstract: Published:15 January 2009 © 2009 Rigo et al; licensee BioMed Central Ltd.


  1. Proportion of correction and compliance to determine success in brace treatment

F. Landauer  and Th. Hofstädter /Orthopaedic Department, PMU – University of Salzburg, Muellner Hauptstr. 48, 5020 Salzburg, Austria /from 4th International Conference on Conservative Management of Spinal Deformities
Boston, MA, USA. 13–16 May 2007/Scoliosis 2007, 2(Suppl 1):S13doi:10.1186/1748-7161-2-S1-S13

The electronic version of this abstract is the complete one and can be found online at: /Published:12 October 2007/© 2007 Landauer and Hofstädter; licensee BioMed Central Ltd.


  1. Chancen und Möglichkeiten von CAD/CAM  in der Orthopädie- Technik erläutert am Beispiel der RSC Korsett Servicefertigung/Gallo Dino, Ortholutions, Königsseestraße 10, 83022 Rosenheim-Germany 

Orthopädie- Technik 10 (2005):704-711/


  1. A series of patients with adolescent idiopathic scoliosis treated with a Rigo System Chêneau (RSC) brace. Primary correction in brace improved by technical evolution /Manuel Rigo E.Salvá Spinal Deformities Rehabilitation Institute, Vía Augusta 185, 08021 Barcelona, Spain from 4th International Conference on Conservative Management of Spinal Deformities
    Boston, MA, USA. 13–16 May 2007/Scoliosis 2007, 2(Suppl 1):S11doi:10.1186/1748-7161-2-S1-S11

The electronic version of this abstract is the complete one and can be found online at: Published:12 October 2007/© 2007 Rigo; licensee BioMed Central Ltd.


  1. Indications for conservative management of scoliosis (guidelines)

SOSORT guideline committee , Hans-Rudolf Weiss, Stefano Negrini, Manuel Rigo, Tomasz Kotwicki , Martha C. Hawes, Theodoros B. Grivas, Toru Maruyama, Franz Landauer / Scoliosis 2006


  1. Scoliosis Intensive Out- Patient Rehabilitation Based on Schroth Method, Manuel Rigo, Gloria Quera-Salvá, Monica Villagrasa, Marta Ferrer, Anna Casas, Clara Corbella, Amaia Urrutia, Sonia Martinez, Nuria Puigdevall E.Salvá Spinal Deformities Rehabilitation Institute, Vía Augusta 185, 08021 Barcelona, Spain


  1. SOSORT/Society On Spinal Orthopaedic and Rehabilitation Treatment/
  2. The Conservative Scoliosis Treatment- 1st SOSORT Instructional Lectures Book/ISBN 978-1-58603-842-7