Dr. Manuel Rigo, Creator of the Rigo Cheneau Scoliosis Brace, interviewed by Dr. Derek Lee
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- Опубліковано 12 лип 2024
- This interview is for educational purposes and covers information provided by Dr. Manuel Rigo, MD, PhD, regarding his opinions based on scoliosis biomechanics and bracing principles. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
1:01 Career path to medicine and scoliosis bracing and physiotherapy.
3:37 "Scoliosis, with potential for progression, is a constant and unpleasant lesson in humility."
4:46 Evolution of the Rigo Cheneau Scoliosis Brace.
8:33 Perspective on the Cheneau "concept" and lack of standardization.
9:21 Contribution to brace biomechanical concepts & the Rigo Classification system.
11:01 Perhaps too late to standardize Cheneau style braces.
11:42 Concept of RASO and Rigo Cheneau bracing.
15:52 Driver of scoliosis is rotation.
15:35 Scoliosis is a growth induced torsion of the spine followed by lordosis.
15:44 RASO is restricted to the scoliotic regions of the spine.
17:25 Most progressive cases of AIS scoliosis are when spine rotation is most prevalent.
17:49 Thoracic lordosis then drives further rotation leading to more severe scoliosis progression.
18:51 More severe curves are produced by thoracic spine rotation, lordosis or both?
21:59 Thoracic spine rotation with little lordosis produces less severe scoliosis curves than thoracic spine rotation with more lordosis which produces more severe scoliosis curves.
23:08 Can rapid spine growth on its own produce scoliosis?
24:03 How do you brace a scoliotic curve with rotation and no lordosis versus a scoliosis curve with rotation plus lordosis?
24:44 Main limitation for bracing is not Cobb angle. Limitation is the amount of lordosis.
26:34 De-rotation braces cannot correct scoliotic lordosis if patient cannot compensate in the sagittal plane. This leads to kyphotic patterns in adjacent regions.
27:01 Lordotic component of scoliosis cannot be corrected with bracing. Bracing cannot apply any direct anterior to posterior force on the spine.
28:29 Only breathing can possibly change lordosis but even this is not possible if the the lordosis is structural and cannot move.
29:25 Since the limitation of bracing is lordosis of the thoracic spine, Dr. Rigo will not brace a scoliosis with a big Cobb angle and severe thoracic lordosis.
29:58 Severe scoliotic curve with severe lordosis is a full contraindication for bracing. Bracing this type of scoliosis will make the scoliosis worse.
31:18 In general, scoliotic curves with some thoracic kyphosis and non-structural thoracic lordosis or flexible spines are appropriate for bracing.
33:07 Is aiming for 50% in-brace correction appropriate?
35:09 How much in-brace correction does Dr. Rigo aim for?
35:40 Poor in-brace correction less than 20% can be enough to stabilize a curve if the patient is very compliant.
36:68 For curves with over 30% in-brace correction, Dr. Rigo will look for more correction with brace adjustments if the spine is flexible and the patient is compensating well.
38:04 Importance of not being too aggressive with in-brace corrections.
38:33 Maximum correction is not always the optimum correction.
39:31 Perspective on braces that over correct scoliosis curves.
31:34 Dr. Rigo looks for no spine compensation and proper breathing mechanics as a priority above Cobb angle in-brace correction.
42:08 Longer term curve stability is due primarily to the reshaping of the trunk/torso.
43:48 Perspective on night-time braces.
44:52 Perspective on double bracing. One brace for daytime, a second brace for night-time.
45: 34 Exercise and bracing.
48:34 No significant difference between general and scoliosis specific exercises while bracing.
50:05 Where would Dr. Rigo focus research to advance bracing technology?
50:31 Appropriate patient selection for bracing.
51:29 Identify patients who respond well to bracing.
53:38 Improve quality of brace through research.
55:03 Research and clinical bracing experience need to be combined for the best bracing innovations.
57:42 The diagnosis of AIS should not define a person's life.
www.drdereklee.com
/ 1198200727630801
www.navigatingscoliosis.com
This interview is for educational purposes and covers information provided by Dr. Manuel Rigo, MD, PhD, regarding his opinions based on scoliosis biomechanics and bracing principles. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
1:01 Career path to medicine and scoliosis bracing and physiotherapy.
3:37 "Scoliosis, with potential for progression, is a constant and unpleasant lesson in humility."
4:46 Evolution of the Rigo Cheneau Scoliosis Brace.
8:33 Perspective on the Cheneau "concept" and lack of standardization.
9:21 Contribution to brace biomechanical concepts & the Rigo Classification system.
11:01 Perhaps too late to standardize Cheneau style braces.
11:42 Concept of RASO and Rigo Cheneau bracing.
15:52 Driver of scoliosis is rotation.
15:35 Scoliosis is a growth induced torsion of the spine followed by lordosis.
15:44 RASO is restricted to the scoliotic regions of the spine.
17:25 Most progressive cases of AIS scoliosis are when spine rotation is most prevalent.
17:49 Thoracic lordosis then drives further rotation leading to more severe scoliosis progression.
18:51 More severe curves are produced by thoracic spine rotation, lordosis or both?
21:59 Thoracic spine rotation with little lordosis produces less severe scoliosis curves than thoracic spine rotation with more lordosis which produces more severe scoliosis curves.
23:08 Can rapid spine growth on its own produce scoliosis?
24:03 How do you brace a scoliotic curve with rotation and no lordosis versus a scoliosis curve with rotation plus lordosis?
24:44 Main limitation for bracing is not Cobb angle. Limitation is the amount of lordosis.
26:34 De-rotation braces cannot correct scoliotic lordosis if patient cannot compensate in the sagittal plane. This leads to kyphotic patterns in adjacent regions.
27:01 Lordotic component of scoliosis cannot be corrected with bracing. Bracing cannot apply any direct anterior to posterior force on the spine.
28:29 Only breathing can possibly change lordosis but even this is not possible if the the lordosis is structural and cannot move.
29:25 Since the limitation of bracing is lordosis of the thoracic spine, Dr. Rigo will not brace a scoliosis with a big Cobb angle and severe thoracic lordosis.
29:58 Severe scoliotic curve with severe lordosis is a full contraindication for bracing. Bracing this type of scoliosis will make the scoliosis worse.
31:18 In general, scoliotic curves with some thoracic kyphosis and non-structural thoracic lordosis or flexible spines are appropriate for bracing.
33:07 Is aiming for 50% in-brace correction appropriate?
35:09 How much in-brace correction does Dr. Rigo aim for?
35:40 Poor in-brace correction less than 20% can be enough to stabilize a curve if the patient is very compliant.
36:68 For curves with over 30% in-brace correction, Dr. Rigo will look for more correction with brace adjustments if the spine is flexible and the patient is compensating well.
38:04 Importance of not being too aggressive with in-brace corrections.
38:33 Maximum correction is not always the optimum correction.
39:31 Perspective on braces that over correct scoliosis curves.
31:34 Dr. Rigo looks for no spine compensation and proper breathing mechanics as a priority above Cobb angle in-brace correction.
42:08 Longer term curve stability is due primarily to the reshaping of the trunk/torso.
43:48 Perspective on night-time braces.
44:52 Perspective on double bracing. One brace for daytime, a second brace for night-time.
45: 34 Exercise and bracing.
48:34 No significant difference between general and scoliosis specific exercises while bracing.
50:05 Where would Dr. Rigo focus research to advance bracing technology?
50:31 Appropriate patient selection for bracing.
51:29 Identify patients who respond well to bracing.
53:38 Improve quality of brace through research.
55:03 Research and clinical bracing experience need to be combined for the best bracing innovations.
57:42 The diagnosis of AIS should not define a person's life.
drdereklee.com
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The last 3 mins from Dr. Rigo had me down on my knees and in tears.... It just hit home with all the emotional ups and down that we went through last year. 😭
Yes!
Thank you very much for this very useful and touching interview.
Our daughter is using Gensingen brave. It is similar to Cheneau-Rigo, it seems. What is the difference between these two types of braces?
What about patients with connective tissue disorders? (ie. Marfan syndrome). Would this bracing technique work as well? Since these patients are a little more flexible than usual. Thanks!
In general flexible curves do better than stiff curves with respect to bracing. You'd have to consult with your orthotist and health team to see what they recommend for your specific situation.
Can you treated scoliosis with 50th degrees without surgery. please tell how to contact you
How exactly does the Rigo Cheneau brace derotate the spine?
That's a good question. I'm not an orthotist or a bracing expert but I've been told that the RC style brace derotates the curve by placing asymmetric pressure on the spine while applying traction.
Take a look at this video for greater detail. ua-cam.com/video/DRqFhgn1T8I/v-deo.html
@@DerekLee thank you
Sir from india anybody who can make for our daughter
Dr. Sajan Hegde in India.
It's a pity you didn't say anything about adult scoliosis patients
Not enough time. You may find this more interesting as it's all about adult bracing.
www.sosort.org/webinars/
@@DerekLee Thank you!