PURPOSE: Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types. METHODS: Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies' officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM. RESULTS: The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction-valves (monocot, bivalve, multisegmented), construction-closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups. CONCLUSION: The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.

Align Clinic LLC and Align Technologies LLC San Mateo CA USA

Boston Children Hospital Harvard Medical School Boston MA USA

Boston Orthotics and Prosthetics Boston MA USA

Children's Mercy Hospital Kansas City MO USA

Department of Biomedical Engineering The Hong Kong Polytechnic University Hong Kong China

Department of Biomedical Surgical and Dental Sciences University La Statale Milan Italy

Department of Orthopedic Surgery Columbia University Irving Medical Center New York NY USA

Department of Orthopedics and Traumatology Acibadem Mehmet Ali Aydinlar University School of Medicine Istanbul Turkey

Department of Orthopedics and Traumatology Tzaneio General Hospital of Piraeus Piraeus Greece

Department of Physical Therapy Faculty of Rehabilitation Medicine University of Alberta Edmonton AB Canada

Division of Orthopaedics Children's Hospital of Philadelphia Philadelphia PA USA

Division of Orthopedics University of Montreal CHU Sainte Justine Montréal QC Canada

DM Orthotics Ltd Redruth UK

H Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery Saint Petersburg Russia

Independent Researcher Lyon France

IRCCS Bambino Gesù Children's Hospital Rome Italy

IRCCS Istituto Ortopedico Galeazzi Milan Italy

ISICO Milan Italy

Kuća Zdravlja D O O Poljička 31 10 000 Zagreb Croatia

National Scoliosis Center Fairfax VA USA

OrthoChiro Montréal QC Canada

Rady Children's Hospital University of California San Diego USA

Rigo Quera Salvá SLP Vía Augusta 185 08021 Barcelona Spain

Rosalind Franklin University of Medicine and Science North Chicago IL USA

School of Health Professions Faculty of Health University of Plymouth Plymouth UK

ScoliCare Kogarah NSW Australia

Scoliosis and Spinal Disease Center Hesperia Hospital GHC SPA Modena Italy

Scoliosis Physiotherapy and Posture Centre Ottawa Ottawa ON Canada

Sheffield Children's NHS Foundation Trust Sheffield Children's Hospital Sheffield UK

SOSORT Boston MA USA

Spine Disorders and Pediatric Orthopedics Department University of Medical Sciences Poznan Poland

Texas Children's Hospital Professor of Orthopaedics Baylor College of Medicine Houston TX USA

West Bohemia University Pilsen Czechia

Eur Spine J. 2022 Sep;31(9):2456-2457. doi: 10.1007/s00586-022-07273-0. PubMed

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