*2.4.2 Nonsurgical orthopedic treatment of 62 adult vertebral deviations treated with adult ARTbrace*

Instability in adulthood is frequent, and surgery is the most frequently offered solution despite the high rate of complications, as there was no alternative to date for thoracic and thoracolumbar curves. Only overlapped bivalve polyethylene braces were used for lumbar scoliosis with good frontal stabilization but no control in the sagittal plane (**Figure 9**). The ARTbrace in Europlex'O which allows an average reduction of 70% for the children has been used since 2015 in the adult for all the deviations.

The results of a consecutive series of 62 patients (6.2% of all ARTbrace patients) were treated between 2015 and 2016, as an alternative to surgery.

**Figure 9.** *Insufficient correction in the sagittal plane.*

**Figure 10.** *Reduction in the frontal plane after decompensation upon arthrodesis.*

*Bracing Adult Scoliosis: From Immobilization to Correction of Adult Scoliosis DOI: http://dx.doi.org/10.5772/intechopen.90196*

Nine patients (15%) which constitute the dropout were not seen at 6 months, which is very little considering the general condition and age of patients. The percentage of dropouts is identical to the previous series of lumbar curves treatments.

**Figure 11.** *Correction of kyphosis in the sagittal plane.*

### **Figure 12.**

*EOS 3D confirms thoracolumbar spine detorsion in ARTbrace.*

Despite the very high rigidity, Europlex'O which needs a precision of 1 mm is therefore as well tolerated as polyethylene.

In the frontal plane, the average in-brace reduction is 27%, slightly higher for lumbar and thoracolumbar curvatures. The reduction to 2 years without brace is 15%, and especially the symptomatology of instability disappears. It is now possible to stabilize all thoracolumbar, thoracic, and double major scoliosis (**Figure 10**).

In the sagittal plane, the average in-brace reduction is 32% and at 2 years without brace of 25% (**Figure 11**).

In the horizontal plane, some characteristic case study with EOS 3D confirms that adult ARTbrace is indeed, as in the child, a detorsion brace. Adult ARTbrace is the only brace to correct kyphosis and thus compensate for the insufficiency of polyethylene whose sternoclavicular support was not tolerated (**Figure 12**).
