Responses to Rigo-cheneau scoliosis brace
Paula Pivko
Description
Collection
Title:
Responses to Rigo-cheneau scoliosis brace
Creator:
Paula Pivko
Date:
10/19/2017
Text:
Hi all thanks to everyone who has responded. We are currently discussing with the doctor how to proceed from here due to the family's financial considerations. Again thanks to everyone who has responded! Paula Martinek, LPO
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This e-mail and any documents attached to it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you receive this e-mail in error, please notify the sender immediately by replying to <Email Address Redacted>
This is a complex brace and requires extensive training in casting and fabrication. A pure Chenau brace is prescribed as part of a comprehensive physical therapy program called Schroth. This would be best discussed with a practitioner who has had the training
Hello,
We've been manufacturing and fitting Rigo Cheneau style TLSO's for over 3 1/2 years now with great results. I've attached a presentation a colleague and I presented at the Australian Orthotic Prosthetic Association congress in 2015 which outlines some of the differences with a Boston and a Cheneau. Our facilities initial training was in Germany at BUFA followed by time spent in Spain with Dr Rigo.
I'd like to say at first that there is a HUGE difference between the styles and the loads and if you have never made one/seen one made before you cannot fully appreciate the differences until you have compared them. I recall reading manuals and trying to fabricate a Rigo-cheneau off a manual I found online and the loads that I put in where absolutely nothing like they are in an actual Rigo-Cheneau.
The casting procedure is also different in that a cast should be taken in standing to maintain the normal sagittal profile and the cast also extends over the shoulders like a vest, rather than using a casting using a frame and flattening out the lumbar lordosis and abdomen like in a boston cast.
With regards to already commencing her menses you need at least 12months of growth remaining for a brace to be effective. Girls in general stop growing 2 years after their first period so it does still have time to be effective at preventing curve progression providing her period did not start more than 12 months ago.
I have no experience with US billing or central fabrication as I am in Australia and fortunately we are fully funded through the public health system. I know there are European central fabricators but as far as I am aware they use a scan and need to complete some training before being able to order/provide the brace.
In all honesty, without familiarity with the brace or training I would either refer on to clinician who does or speak to the referring physician about providing an alternative style scoliosis brace. I would certainly look into training though if you provide a scoliosis bracing service as our experiences with it have all been positive although like anything it does have a very steep learning curve!
The closest you will get is a Boston 3D TLSO. Rigo brace is not covered by any insurance, no codes and costs about 5 grand. Only two offices in the US can do them because you need to take a course offered only in Canada.
Hi Paula. There is a training course in Germany for this type of brace...the principles aren't that different from other scoliosis braces but it is more aggressive than Boston type, and it employs techniques to get more derotation out of the spine. We custom make them from a cast and the driving force for the brace was a physiotherapist who specializes in the Schroth method of physiotherapy for scoliosis. There is a company that custom makes them but have not looked into them <URL Redacted>
< <URL Redacted> >
< <URL Redacted> >
You need to be a certified WCR clinician in order to do this TLSO. It is only fabricated at the Align Clinic in San Mateo, CA.
Get in touch with the office mgr there and they will assist. Contact info below:
Anthony New
<Email Address Redacted>
14 is a little old to obtain the correction that cheneau normally does. It can be casted and digitized. I always scan and use cad cam to modify and create the mold. It is much easier to quantify the rotation corrections in the brace. A lot of these braces are done with a clear plastic in Europe that is little expensive. I would suggest that your first one have a clear aspect to it to help judge effectiveness with hand casting. Most likely this teenager is beyond bracing of any kind. I understand trying anything before the knife but within reason. Good luck with the spinal. Not sure who can central fan this sorry. I make my own. L-codes are similar to Boston scoli and add accessory parts as needed.
Many years ago we tried to become a certified location to provide the Rigo cheneau style TLSO. Our investigation revealed that we would have to fly to Germany for a week with a orthopedic surgeon, physical therapist, a patient demonstrator, and their parent to do training and test fitting etc. One of our local competitors, the national scoliosis center, provides this type TLSO. We have been told by Patients that have declined to follow treatment there that typically they are billed as a deluxe item coding out to around $10,000 per TLSO. We have instead invested time and energy into doing the Gomez style TLSO which visually looks similar and has many similar principles in design to the Rigo Cheneau TLSO. To the best of my knowledge there are currently only three licensed providers to that can provide this patented product inside US one here in the Washington DC area one up in Maine and one in California. They do not central fabricate to non-licensed facilities. Protech up in Boston will make you a knock off non-label Rigo Cheneau style TLSO. They had one of the disciples that worked side-by-side with Dr. Rico in Germany come and teach a small class to us about the proper impression taking techniques. Basically it boils down to using knee flexion to reduce lordosis, applying triangles to the ASIS, using a tight waist belt to delineate the waist, and an overhead rig to have the arms pull up over the head you then wrap the body as you would a regular TLSO.
I would call Martin up and ProTech and ask him about this if this is something you are interested and they do great work.
From what I’ve experienced the places that will fab it want 3000 for the brace. The biggest problem with this brace is that every company does their own version of the brace and so based on the studies I saw it was no better than a Boston so I educated my doctors and have a local PT if the family want to add therapy into the treatment plan.
CONFIDENTIALITY NOTICE
This e-mail and any documents attached to it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you receive this e-mail in error, please notify the sender immediately by replying to <Email Address Redacted>
This is a complex brace and requires extensive training in casting and fabrication. A pure Chenau brace is prescribed as part of a comprehensive physical therapy program called Schroth. This would be best discussed with a practitioner who has had the training
Hello,
We've been manufacturing and fitting Rigo Cheneau style TLSO's for over 3 1/2 years now with great results. I've attached a presentation a colleague and I presented at the Australian Orthotic Prosthetic Association congress in 2015 which outlines some of the differences with a Boston and a Cheneau. Our facilities initial training was in Germany at BUFA followed by time spent in Spain with Dr Rigo.
I'd like to say at first that there is a HUGE difference between the styles and the loads and if you have never made one/seen one made before you cannot fully appreciate the differences until you have compared them. I recall reading manuals and trying to fabricate a Rigo-cheneau off a manual I found online and the loads that I put in where absolutely nothing like they are in an actual Rigo-Cheneau.
The casting procedure is also different in that a cast should be taken in standing to maintain the normal sagittal profile and the cast also extends over the shoulders like a vest, rather than using a casting using a frame and flattening out the lumbar lordosis and abdomen like in a boston cast.
With regards to already commencing her menses you need at least 12months of growth remaining for a brace to be effective. Girls in general stop growing 2 years after their first period so it does still have time to be effective at preventing curve progression providing her period did not start more than 12 months ago.
I have no experience with US billing or central fabrication as I am in Australia and fortunately we are fully funded through the public health system. I know there are European central fabricators but as far as I am aware they use a scan and need to complete some training before being able to order/provide the brace.
In all honesty, without familiarity with the brace or training I would either refer on to clinician who does or speak to the referring physician about providing an alternative style scoliosis brace. I would certainly look into training though if you provide a scoliosis bracing service as our experiences with it have all been positive although like anything it does have a very steep learning curve!
The closest you will get is a Boston 3D TLSO. Rigo brace is not covered by any insurance, no codes and costs about 5 grand. Only two offices in the US can do them because you need to take a course offered only in Canada.
Hi Paula. There is a training course in Germany for this type of brace...the principles aren't that different from other scoliosis braces but it is more aggressive than Boston type, and it employs techniques to get more derotation out of the spine. We custom make them from a cast and the driving force for the brace was a physiotherapist who specializes in the Schroth method of physiotherapy for scoliosis. There is a company that custom makes them but have not looked into them <URL Redacted>
< <URL Redacted> >
< <URL Redacted> >
You need to be a certified WCR clinician in order to do this TLSO. It is only fabricated at the Align Clinic in San Mateo, CA.
Get in touch with the office mgr there and they will assist. Contact info below:
Anthony New
<Email Address Redacted>
14 is a little old to obtain the correction that cheneau normally does. It can be casted and digitized. I always scan and use cad cam to modify and create the mold. It is much easier to quantify the rotation corrections in the brace. A lot of these braces are done with a clear plastic in Europe that is little expensive. I would suggest that your first one have a clear aspect to it to help judge effectiveness with hand casting. Most likely this teenager is beyond bracing of any kind. I understand trying anything before the knife but within reason. Good luck with the spinal. Not sure who can central fan this sorry. I make my own. L-codes are similar to Boston scoli and add accessory parts as needed.
Many years ago we tried to become a certified location to provide the Rigo cheneau style TLSO. Our investigation revealed that we would have to fly to Germany for a week with a orthopedic surgeon, physical therapist, a patient demonstrator, and their parent to do training and test fitting etc. One of our local competitors, the national scoliosis center, provides this type TLSO. We have been told by Patients that have declined to follow treatment there that typically they are billed as a deluxe item coding out to around $10,000 per TLSO. We have instead invested time and energy into doing the Gomez style TLSO which visually looks similar and has many similar principles in design to the Rigo Cheneau TLSO. To the best of my knowledge there are currently only three licensed providers to that can provide this patented product inside US one here in the Washington DC area one up in Maine and one in California. They do not central fabricate to non-licensed facilities. Protech up in Boston will make you a knock off non-label Rigo Cheneau style TLSO. They had one of the disciples that worked side-by-side with Dr. Rico in Germany come and teach a small class to us about the proper impression taking techniques. Basically it boils down to using knee flexion to reduce lordosis, applying triangles to the ASIS, using a tight waist belt to delineate the waist, and an overhead rig to have the arms pull up over the head you then wrap the body as you would a regular TLSO.
I would call Martin up and ProTech and ask him about this if this is something you are interested and they do great work.
From what I’ve experienced the places that will fab it want 3000 for the brace. The biggest problem with this brace is that every company does their own version of the brace and so based on the studies I saw it was no better than a Boston so I educated my doctors and have a local PT if the family want to add therapy into the treatment plan.
Citation
Paula Pivko, “Responses to Rigo-cheneau scoliosis brace,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/208841.
