New device for scoliosis braces after Rigo.

A brace component to control upper thoracic scoliosis treated with spinal braces.

A new RSC® Brace component — the D-modifier to adapt on TLSO orthoses.

There are various technical and therapeutic approaches regarding how upper thoracic or so-called “double/triple major” curvatures are dealt with. Some experts do not pay any attention at all to the special circumstances.

rsc rigo cheneau scoliosis brace to work on upper thoracic curves of the spine

Scoliosis with upper thoracic curve with a D-modifier component attached on the brace, it pusch n the apex and achieves in the ska tim horizontal translation of the neck head area – like specific physiotherapeutic exercises (BSPTS)


rsc rigo scoliosis brace three point system in tlso orthoses to correct spine

scoliosis – biomechanics and lever, the tree point system to correct upper thoracic scoliotic curves.

With the so-called upper thoracic or double/triple major scoliosis curvatures, the technical challenge is to build the scoliosis orthosis so that the shoulder-neck area in which the curvature is displayed can be aligned perpendicular.

According to the Lenke classification, the apical vertebra is localised between the second and sixth thoracic vertebra (Th 2 and Th 6).

Dr Lawrence G. Lenke is the leading expert for surgeries of complex spinal deformities. He published his detailed – and in comparison with the King classification – more complex classification of idiopathic scoliosis types in 2001.

The RSC Brace (scoliosis brace) has provided specific biomechanical designs in order to generate a fulcrum by means of a so-called “hypomochlion” (fulcrum for support or to attain a leverage effect) that enables straightening via the apex of the upper curvature towards a perpendicular line.

In principle, so-called “three-point systems” are always built into a trunk orthosis for correction in the frontal plane.The third point required for correction with upper thoracic curvatures would be located in the patient’s neck or head area in order to function as a fulcrum.

hypomochlion in rsc rigo cheneau scoliosis brace tlso to correct upper thoracic curves

A hypomochlion is a pivot point to support or achieve leverage, the biomechanical design is integrated into the RSC brace scoliosis orthosis

Technically, a solution can usually be found in these cases. However, the implementation entails considerable cosmetic restrictions for brace wearers,
because the components required for correction usually have an effect via strap systems in the neck area.

Such designs are ordinarily refrained from, because the patient’s psychological strain is not in relation to the anticipated result.  A new approach regarding how the upper thoracic curvature of a scoliosis can be corrected with an additional component on the brace has its origin in physiotherapy.

The Barcelona Scoliosis Physical Therapy School (BSPTS) developed by Dr Manuel Rigo is based on the proven Schroth therapy. The D-modifier component was developed after being derived from physiotherapeutic exercises.

D modifier stems from the terminology of the scoliosis classification developed by Rigo and is added as a supplement to the four basic types if an upper thoracic curvature can
develop or is already manifested with a scoliosis.

tlso scoliosis rsc brace ortholutions rigo cheneau trunk orthoses to correct upper thoracic spine

D-modifier TLSO trunk orthoses component before adaptation on the RSC® Brace – check before the first fitting

The D-modifier component generates compression on the upper thoracic apex (rib hump)
and this is accompanied by a horizontal displacement (translation) of the head towards the centre of the body.

This is generated by means of a strap specifically mounted on the D-modifier.
The biomechanical effect is painstakingly examined by an orthopaedic technician.

If the D-modifier component is incorrectly implemented, the effect – just like with the physiotherapeutic exercises – can fail to materialise, or else even negatively influence the situation, which is more likely.

The D-modifier component is put on at night or at home to spare the scoliosis patient the cosmetic disadvantage in everyday life. In comparison with conventional strap designs, a clearly improved implementation of required corrective forces and the associated biomechanical effect is shown with the new approach.

The new D-modifier component has proved to be a useful supplement for trunk orthoses for correction of an upper thoracic scoliosis.

Social life is less negatively influenced, because the component is individually adaptable. Consequently, compliance and the wearing times of trunk orthoses are therefore increased, which leads to a better overall result.