The technology for treating the spine using a corset was created in the early 70s by the French doctor Jacques Chenault, after whom orthopedic corsets are now called, the design of which is based on the principle of “mirroring” the deformity.
A modern corset is a design that is made individually for each patient from polymer materials with a system of fasteners and special elements to normalize the position of the vertebrae and restore spinal function.
The Chenot corset is created in such a way that the spine restores its normal shape.
At the moment, this is the only technology that allows treating idiopathic scoliosis and spinal deformities of other origins without surgical intervention. Moreover, wearing a corset in many cases is the only treatment option. For example, when surgery is impossible for medical reasons.
Corset therapy in Russia
The question arises: why doesn’t everyone who has problems with the spine use Chenault’s technology?
Despite all the achievements of modern medicine, there are still several factors that hinder the spread of technology.
Medicine has its own unspoken “hierarchy”, in which surgeons are at the top, and orthopedists involved in conservative treatment are significantly lower. Although a talented orthopedist with good education and experience can work real miracles, returning people to health and a high quality of life without surgical intervention.
Skepticism towards orthopedics creates a vicious circle. People, not trusting conservative treatment methods, prefer surgery. Surgical techniques (and surgeons) continue to be the most sought after. And orthopedic approaches and methods are in the shadows.
In this situation, orthopedists have neither the motivation nor the opportunity to demonstrate the true capabilities of modern technologies. This leads to sad results. The introduction of effective conservative methods is slow and often very distorted, as happened with Chenault corsets.
Contraindications
In the absence of health problems (other than spinal dysfunction), wearing a corset is safe. However, in each specific case, relative and absolute contraindications can be identified.
- Relative contraindications. As a rule, they are temporary, in some cases they can be ignored (with mandatory agreement with the doctor). Such contraindications may include skin diseases, the foci of which are located in areas of contact with the corset.
- Absolute contraindications. Lifelong, treatment with a corset is incompatible with them. For example, acute and chronic diseases of the respiratory and cardiovascular systems; pathologies of the musculoskeletal system.
The presence and severity of contraindications can only be determined by a doctor; amateur performance is unacceptable here. “Suppressing” alarming symptoms can lead to deterioration of health and even disability.
What's wrong with Chenault's corsets?
The Chenot corsetry technology itself is almost 50 years old, and its application still requires significant effort and expense:
- We need highly qualified specialists who can correctly diagnose and prescribe corset treatment. Diagnostics means not only the identification of the disease and its severity, but also the correct choice of the type of corset, its manufacture, and support during long-term treatment of the patient.
- Sophisticated equipment is required to create corsets that are effective and as comfortable to use as possible.
- We need special materials that will make the corset light, hygienic and at the same time effective.
The combination of all three of these factors is a prerequisite for creating a Chenault corset - and at the moment in Russia this is practically very difficult to achieve.
The products that we produce in St. Petersburg are made from German-made materials and are effective tools for the treatment of idiopathic scoliosis.
Content:
- Reasons for use
- Need for use
- Types of Posture Corsets
- Functions of posture corsets
- Selection rules
- Summary
For various back diseases and curvature of posture, orthopedists recommend using special corsets. They help maintain the correct position of the back, bring the shoulder blades together, and reduce pain. There are several types of devices, so it is recommended to prepare and learn how to choose a posture corrector.
“Chenault type” corsets
For the reasons described above, “Chenault type” corsets are often found in Russia, which are manufactured with significant violations of technology, which does not lead to the expected results.
“Chenault type” corsets differ from those produced using original technology in that unsuitable materials are used to create them. For example, heavy and very hard plastic. As a result, the corset turns out to be very difficult to use and significantly worsens the patient’s quality of life. At the same time, it does not always have a sufficient corrective effect.
These corsets are cheaper than the original ones. At the same time, even doctors do not always see and understand the difference between a real Chenault corset and a “Chenault type” product. Of course, the lack of skills in working with original technology leads to the fact that the prescribed treatment does not give the desired results and sometimes even causes harm.
What types of posture correctors are there?
Posture correctors are divided according to the degree of fixation: medium and strong. Models with a medium degree of fixation are needed for moderate curvatures, juvenile osteochondropathy, “flaccid” posture with poorly developed muscles, and pain syndrome due to osteochondrosis. Strong fixation models are prescribed in severe cases of spinal deformities, with rapidly progressing forms of scoliosis/kyphosis.
Supportive correctors and recliners without rigid inserts are suitable for getting rid of mild stoop. Serve to maintain correct physiological posture and prevent scoliosis. Corrective reclinators are used for the treatment and correction of diagnosed (established) spinal pathology.
Correctors are also divided according to the patient’s age – into adults and children.
What does the use of low-quality “Chenault type” corsets lead to?
At best, there is no result at all or it is minimal. That is, the patient had to spend several months in a rigid corset, experiencing constant inconvenience and all in vain. At the same time, corsets (even of poor quality) are not cheap - about 20-30 thousand rubles. This money ends up being wasted. And if you consider that the treatment is accompanied by massage, swimming, and gymnastics, then the costs are very significant and it’s a shame to give such an amount “for nothing.”
It is precisely such cases of unsuccessful treatment that give rise to rumors and myths about the ineffectiveness of corsets. In fact, the problem is not in the technology itself, but in the incorrectness of its application and the “handicraft” methods of creating corsets.
In the worst case, wearing a low-quality or incorrectly selected corset leads to worsening of the deformity. In this case, the patient generally loses the ability to hold his back without a corset, i.e. and there is no effect and he feels bad without a corset.
At the same time, the original and effective corset does not interfere with breathing or muscle development. That is, the body develops naturally, and such treatment does not have a negative effect on other systems.
Professor NNIITO gave a detailed interview about scoliosis
Mikhail Mikhailovsky - Doctor of Medical Sciences, Head of the Department of Pediatric and Adolescent Vertebrology at the Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya. L. Tsivyan.
For almost fifty years, Mikhail Vitalievich has been working with patients with scoliosis: examining, prescribing treatment, and operating. The Novosibirsk News correspondent spoke with a doctor and found out why improper sitting at a desk cannot lead to the development of scoliosis, how to correct spinal deformities and why there are no official vertebrologists. — Mikhail Vitalievich, what is scoliosis?
Are these any curvatures of the spine? - No. There are different types of deformation.
Scoliosis is a collective concept. There are several dozen forms of scoliosis, depending on its nature. The most common is the so-called idiopathic scoliosis, that is, of unknown origin. Experts have been fighting for a hundred years, but they still cannot understand the reason. It is “understood” only by illiterate people who love to deceive the audience.
I recently heard a wonderful lecture from an amateur who says that all diseases of the spine are absent, they do not exist, and everything depends on only one thing - subluxation of the first vertebra.
But in fact, we don’t know anything - and therefore we don’t know how to treat. I mean, there is no what we call pathogenetic treatment. This is how, for example, there is a vaccine for Covid - this is pathogenetic prevention, or pneumonia is treated with antibiotics. But we don’t know how to deal with scoliosis like this. But its main symptom—curvature of the spine—can be eliminated. Very rude, very clumsy, because this is a big surgery with blood loss. But we can do this.
However, there are forms of scoliosis that do not need to be treated. They are so mildly expressed that they do not pose any problem for the patient.
Photo: Vladimir Dubrovsky
— You said that spinal curvature is the main symptom of scoliosis. What other ones are there?
— A lot of changes occur in the patient’s body. And we never know whether this is a cause or a consequence of scoliosis. And in the heart, and in the lungs, and in the intestines. But this is already with far, far advanced forms. There are also changes in the nervous system and endocrine system. Most likely, this is the reason, but we cannot yet catch it in order to say that here we need to act in this way, and then there will be no scoliosis.
— Are there more or fewer patients with scoliosis over time?
- No more, no less. But there is a difference in the number of patients depending on the region, a difference between nations.
For example, in South Africa, whites get sick much more often than blacks. People in Israel get sick more often than, for example, Arabs. It is also believed that the further north you go, the worse the scoliosis. Why - we don't know.
— Under what conditions does scoliosis not need to be treated?
- These are weak, light forms. Any scoliosis occurs in its own way. There is a course that we call malignant - when a child of one and a half to two years already has a severe hump, which is difficult to look at, especially for the mother, and such a sight also makes me sad. And there is deformation, when you can barely see it in the picture. Such deformation does not interfere with life and does not create mental problems. There is no pain, no cosmetic defect, the patient lives calmly.
A lot depends on mentality. To some, even a mild form seems like a terrible illness, but to others it’s normal.
The fact is that scoliosis is also divided by age: early, teenage, and adult.
Typically, the peak of progression is 12-14 years of age, puberty, puberty. As the organism grows, the deformation grows along with it. When growth ends, deformation stops. And sometimes it continues, albeit very slowly, to progress, sometimes throughout life. It's unpredictable. We are forced to observe, look, invite the patient every year, sometimes every six months, take pictures, compare and only then make a decision. It's long, tedious, but necessary.
When they say that scoliosis is a lateral deviation, this is wrong. The spine twists around a vertical axis - this is the formation mechanism. And this twisting is accompanied by deformation in all three planes. From here to the side, and forward, and backward. Everyone is afraid of squeezing organs, but this only occurs in very severe, advanced forms, which are now becoming less and less common, fortunately. We manage to catch them in time, correct them and not lead them to such passions.
— You said that the causes of scoliosis are unknown. That is, teachers and parents needlessly scare children that if they sit at their desks incorrectly, they will develop scoliosis?
— Incorrect landing has nothing to do with scoliosis. It is humanity's passion to find simple solutions to complex problems. When I give a lecture to students, I always ask: “Who in childhood was told by their mother, teacher, or doctor: sit straight at your desk, otherwise you will develop scoliosis?” Everyone raises their hands. Because it's easier to explain this way. But in reality this has nothing to do with reality.
I have four books on my shelf, they were written by my friend Professor Dudin, who studies the origin of scoliosis. The conclusions are that, due to very complex mechanisms that we cannot fully comprehend, an imbalance in the longitudinal growth of the spine and spinal cord occurs, which includes new very complex mechanisms, and this arch is formed. Apparently this is genetically determined. This is a very complex process that we are not yet able to understand.
Photo: Pavel Komarov, nsknews.info
— And is it impossible to predict at screening or immediately after birth whether a child will have scoliosis?
- No, absolutely. Although there are forms of congenital scoliosis, when scoliosis is already in the womb. This is due to known reasons - improperly developed vertebrae and discs.
But when it comes to idiopathic scoliosis, the child is born straight, but sooner or later curvature begins.
— What should parents pay attention to? When should I take my child to the doctor?
- There is no need to panic, because there is no urgency in these situations. It's not Covid, it's not an ulcer. Now, in a week, in a month, nothing will change.
You need to look at how the child looks, how symmetrical his body is: shoulder girdles, waist triangles, back. And if something is uneven, it is important to show the child to a specialist who deals specifically with spinal deformity. And no panic. No. You just need to go to a specialist, get examined and make a decision. Most often it will be either “go home, your child is healthy” or “let’s watch the child and then panic.” There should be no haste, no horror, no intimidation.
— What can a specialist prescribe for treatment after observations and examinations? Corset?
— We prescribe a corset only in certain cases.
Because corsets - and there are a lot of options - work only at a certain age: when there is a surge in activity and growth of the arch. When she gains 5-10-15 degrees every year, the corset is very useful, at least to stop the deformation, this is also very important. When the growth of the body stops, the corset ceases to be relevant.
Everything else that is prescribed to patients with scoliosis: massage, physical therapy, swimming - all this cannot in any way correct the deformity. This is all general strengthening treatment, which is useful in itself, just as it is useful for any person to swim and not sit for hours so as not to hurt the back. But this has no therapeutic function, it would be too simple. You cannot give a massage and cure scoliosis.
Unfortunately, a lot of bad people are trying to prove that they can correct the deformation with their hands. Such specialists sometimes even turn to me so that I can help promote their business with my name. And when you ask to send at least one radiograph of a cured patient, the letters from them stop. These people are not able to prove the effectiveness of the technique, and dishonestly making money from fear is welcome.
Massage, of course, does not make the patient feel bad. This is useful. But there is no need to create illusions that massage will correct spinal deformity. It’s even worse to think that the deformity can be corrected with manual therapy. This is a serious branch of medical knowledge. I studied it myself, and at a serious school in Novokuznetsk. This section is important, but in relation to scoliosis, manual therapy cannot give anything.
Photo: Vladimir Dubrovsky
— In what case is surgery prescribed for a patient with scoliosis?
— Scoliosis affects approximately 1% of the population. Of this percentage, another one percent needs surgery, that is, one person in several thousand.
Spinal deformity is measured using x-rays. And if the curvature has reached 40, some experts consider 45 degrees - this is already an indication for surgery. In addition, the indications are the rate of progression, pain syndrome, respiratory dysfunction and, most importantly, the desire of the patient.
Scoliosis is a 90% girl's disease. Also, by the way, it is unknown why. When a girl is 13-15 years old, she begins to feel almost like an adult and suddenly finds out that she has a crooked back - this is a tragedy. And when she really wants to get rid of it, but there are no options to help other than surgery, then we explain what will happen if we operate and if we don’t operate. The decision is made by the patient and her parents. We never impose, with rare exceptions, when it is really necessary.
— How is such an operation carried out?
— A special metal structure is installed on the spine. It contains screws and hooks. It is placed on the spine, an incision is made in the back. With the help of this design, the deformity is corrected and the spine is fixed in the correct position. Usually the deformity can be completely corrected, at least externally, and what is already there in the picture does not matter, the main thing is that the girl feels straight.
Then bone grafting is done to keep everything still. There is no need to remove the gland; it remains for life. You can do everything with it: live, work, play sports, have children. Of course, it’s not very healthy that part of the spine becomes immobile, but so far there is no method that would both correct the deformity and maintain mobility.
Photo: Vladimir Dubrovsky
- Do they only operate on children? Or adults too?
- Absolutely everyone. We have patients up to 50 and even older. I repeat: it’s mostly women who get sick, and sometimes such a woman gets married, gives birth to children, and then remembers that she has scoliosis and runs to have surgery. I ask: “Why now?” - “Well, that’s what I decided.” - “What does your husband think?” - “Who would ask him?”
That's why we operate on everyone. There is a difference in the effect, not very big, but there is. And this concerns not so much the result as the risk of complications. In adults, the risk is always higher, this is inevitable.
Complications are of two types: general surgical and specific to this method. This method is specific, for example, to a fracture of a metal structure. Sometimes this does not pose any problem at all: there are more than 20 screws, one is broken - and God bless him, there is no need to redo it, and besides, the patient does not feel any discomfort. But if the rod breaks, you will have to replace it; a minor operation is required. But this rarely happens - in two cases out of a hundred.
Sometimes there is suppuration due to a foreign body in the wound. But this is also rare - one case out of a hundred. And we can cope with all this.
The hardest thing, the thing they fear the most, is what can paralyze. This is the rarest of all severe complications - according to our data, three cases per thousand patients, and with a very serious deformity. It is not always possible to achieve recovery. And this is a terrible tragedy, because every patient is an individual with his own history, destiny, and parents.
And although specialists work hard to prevent such complications, sometimes they happen.
Photo: Vladimir Dubrovsky
— Why are there so few doctors who deal with scoliosis?
— Because therapists are trained by the Department of Therapy, surgeons by the Department of Surgery, but no one trains vertebrologists, there are no such departments, there is no such specialty officially. Because if it is officially recognized and included in the register of specialties, then a lot needs to be created, departments where it is taught. It's expensive, and we haven't achieved it yet. But we fight. We'll probably get there someday, but not yet.
That’s why there are only a few of us right now—several centers in Russia. Because of this, we have few patients undergoing surgery—only 1,500, but we need more.
How to distinguish a real Chenault corset from a “Chenault type” product?
- 3-D technologies. For the manufacture of our corsets, 3D modeling technologies are used, which ensures high accuracy and almost perfect fit of the corset on the patient’s body. Therefore, it would be more correct to call our corrective corsets Chenault 3D corsets.
- Individual production. To create a high-quality corset, it is necessary to be examined by a doctor, make a diagnosis, take x-rays in a standing position, and take special measurements from the surface of the body using special instruments. Therefore, each Chenault 3D corset is a piece product and mass production of such products does not exist.
- Price. The cost of manufacturing a corset is very high and its price cannot be lower than 50-70 thousand rubles. Therefore, you should not be “tempted” by tempting prices of several thousand rubles. This will be a different product, since the production technology is not followed.
On the Internet you can find private advertisements for sale. As a rule, these are used corsets that were left over from treatment. Under no circumstances should you buy such corsets. The likelihood that someone's corset will suit you is zero. It will be a waste of money with the risk of completely ruining your health.
Creation of the Chenault corset using original technology
Our corsets are made in St. Petersburg using modern techniques, using 3D corset modeling. Only German materials are used to make the corset.
In each case, the cost of the corset is calculated individually, based on the examination of the patient and his treatment plan.
- To make a corset, an x-ray and physical parameters of the patient are required. In total, about 40 measurements are taken in different body positions. Based on these data, the orthotist designs the design of the corset, taking into account all the individual characteristics of the scoliotic arches.
- Then a virtual 3D model is created, which is subsequently made from polyurethane and then from special plastic.
- The finished Chenot 3D corset is adjusted and adjusted directly on the body using a system of Velcro fasteners. The doctor evaluates the corrective function of the corset.
How does a posture corrector work?
The design of the corrector consists of rings or belts - straps that cover the shoulder joints in front, and are crossed in a figure eight at the back at the level of the shoulder blades. From the back, they can cover only the thoracic spine or the entire back. Corrector models are made of elastic fabric. To enhance the intensity of the impact, rigid inserts (polyurethane or metal ribs) are used, which exert pressure on the curved areas of the back.