Figure 5

TLSO-type brace with low axilla, thoracic and lumbar pads which presents a worse in-brace situation. a: Patient out-of-brace on July 2013 presented with a right thoracic curve of 22-degree Cobb angle at T7 to T12 with the curve apex at T9; and a left lumbar curve of 22-degree Cobb angle at T12 to L4 with the curve apex at L2-3. Although the upper end-plate maximum inclination was T7, the curve inclined up to T7-T6-T5. b: Patient on July 2013 in TLSO-type brace which the patient reported to be a comfortably fitting brace. c: The TLSO-type in-brace X-ray presented the thoracic pad at T10 with the pad pressures and size of pad covering approximately T10 to T12/L1, and the counterforce at the left axilla at T 7-8. As a result, the in-brace X-ray showed a scoliosis which was worse in-brace compared to out-of-brace. TLSO-type in-brace was thoracic 18.5 degree Cobb and lumbar 25 degree Cobb angles. This was the direct result of firstly, the axilla extension being too low, which caused the buckling effect, and secondly, the low thoracic pad blocking the lumbar correction. This configuration was causing lumbar curve progression in the brace.