Case report: AID, a new principle of correction to treat proximal structural curve with a brace

Case report A 14 year old was diagnosed with AIS at 10 years of age. In a first X-ray from February 2010 it was noted a right thoracic curve measuring 7o Cobb, combined with a left lumbar measuring 7o Cobb. Proximal thoracic region was not measurable. One year later, February 2011 the Cobb angles progressed to 18o and 13o respectively, and progression was confirmed on September 2011 with a Cobb angle of 24o in the main thoracic and 26o in the lumbar curve. She was treated with a Boston brace showing poor inbrace correction, with 17o lumbar, 22o main thoracic and 19o proximal curves. In a new X-ray out of brace on May 2012 the angles were 19o, 18o and 21o. With her second Boston brace the values were 19o, 18o and 25o respectively. On December 2012 and with no new reference out-brace the brace was changed to a classical Chêneau type brace, with no in-brace X-ray, mainly due to the over-exposition. Menarche on April 2013. New X-ray on June showed a progression to 21o, 25o and 31o respectively. Due to the bad evolution of the proximal curve we designed a removable superstructure with a combined mechanism: compression on the convex proximal curve and three-point system. After using partial time this super-structure and confirming an acceptable in-brace correction of the proximal curve, her last X-ray on January 2014 showed a stable curve 21o, 27o and 30o respectively, at Risser 3-.