Scoliosis — Rigo Chêneau Bracing

Evidence-based scoliosis management for children and adolescents in Belfast

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Evidence-Based Scoliosis Management

Scoliosis affects approximately 2-3% of the population, most commonly appearing during adolescence. At Bull Orthotics, we provide specialist Rigo Chêneau bracing — a clinically proven approach to managing progressive scoliosis curves.

Led by HCPC-registered specialist Jonathan Bull, with over 20 years of experience in orthotic care, we offer comprehensive assessment, custom brace fabrication, and ongoing support throughout your treatment journey.

Patient fitted with custom Neja Rigo Chêneau brace — Each brace is individually designed and fabricated

Understanding Scoliosis

What is Scoliosis?

Scoliosis is a three-dimensional deviation of the spine, involving lateral curvature and rotation. It's typically measured using the Cobb angle on X-rays, with curves greater than 10 degrees considered clinically significant.

Who Does It Affect?

Most commonly affects adolescents aged 10-18
More prevalent in females, especially for larger curves
Can also occur in younger children or adults
Often detected during school screenings or routine examinations

Assessment and Monitoring

Scoliosis assessment typically involves:

Clinical examination — Postural assessment and Adam's forward bend test
X-ray imaging — Measurement of Cobb angle and curve pattern
Skeletal maturity assessment — Risser sign or bone age
Ongoing monitoring — Regular reviews to track progression

Note: We work closely with your consultant and multidisciplinary team to ensure coordinated care.

The Rigo Chêneau Approach

The Rigo Chêneau brace is a modern evolution of the original Chêneau design, incorporating advanced biomechanical principles and three-dimensional correction strategies.

🎯 Curve-Pattern Specific

Each brace is designed according to the specific curve pattern classification, ensuring targeted correction forces are applied where needed.

🔄 3D Correction

Addresses the spine's lateral deviation, rotation, and sagittal alignment simultaneously for comprehensive correction.

💪 Detorsion Mechanism

Specific expansion chambers and compression zones work together to reduce spinal rotation and improve alignment.

🏃 Functional Design

Allows for breathing, movement, and daily activities while maintaining corrective forces throughout wear time.

Wear Schedule and Expectations

Wearing time is prescribed based on individual needs, typically ranging from 18-23 hours per day. The brace aims to:

Slow or halt curve progression during growth
Provide in-brace correction to improve spinal alignment
Support postural awareness and core stability
Enable continued participation in age-appropriate activities

Important: Bracing outcomes vary based on curve type, skeletal maturity, wear compliance, and individual factors. We make no guarantees about specific results and encourage open discussion about realistic expectations.

Personalise Your Brace

We use Neja braces, which offer a wide range of colors and patterns to help make wearing the brace a more positive experience. Choose a design that reflects your child's personality and interests.

Available Colours and Patterns

Browse through our selection of brace designs below. From vibrant patterns to calming colours, there's something for everyone. The appearance of your brace doesn't affect its function — all designs provide the same corrective benefits.

Aqua

Cats & Dogs

Feather

Ginko

Jungle

Life Spirit Essence

Life Spirit

Lori

Ninja Cats

Silk

Watercolour

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During your consultation, we'll show you the full range of available options and help you choose the perfect design.

Your Treatment Journey

From initial consultation to ongoing adjustments, we guide you through each step with clear communication and compassionate care.

Day 1

Initial Assessment

Comprehensive clinical evaluation including X-ray review, postural assessment, and discussion of treatment goals. We'll take measurements and 3D scans to begin designing your custom brace.

2 weeks after assessment

First Brace Fitting

Your custom-fabricated brace is ready for initial fitting. We'll ensure proper fit, demonstrate how to wear it correctly, and make any necessary adjustments. You'll receive detailed care instructions and wearing schedule.

1-2 weeks after first fitting

Workshop Adjustments (if needed)

Occasionally, more complex adjustments are required at our workshop facility. If needed, we'll schedule a second fitting to ensure optimal comfort and corrective function.

1-2 weeks after fitting

First Review in Brace

Check-in appointment to assess how you're adapting to the brace, address any comfort concerns, and make minor adjustments. We'll review your wearing compliance and answer any questions.

3 months

3-Month Review

Comprehensive review including assessment of brace fit, wear patterns, and any growth changes. Adjustments made as needed to maintain optimal correction and comfort.

6-9 months

6-9 Month Review & Replacement

With growth, a new brace is typically required. We'll take fresh measurements and scans for your replacement brace, ensuring continued effective treatment as you grow.

Clinical Evidence and Best Practice

Scoliosis bracing, including Rigo Chêneau methods, is supported by clinical evidence and international guidelines. Research shows that appropriate bracing during growth can reduce the risk of curve progression.

International Guidelines

SOSORT (Society on Scoliosis Orthopaedic and Rehabilitation Treatment) guidelines
NICE (National Institute for Health and Care Excellence) recommendations
Scoliosis Research Society position statements

Every patient is unique. Clinical decisions should be made in consultation with your orthopaedic consultant or specialist. We provide orthotic expertise as part of your broader care team.

Is Rigo Bracing Right for You?

Typical Indications

Rigo Chêneau bracing may be appropriate for:

Progressive curves typically between 20-45 degrees (Cobb angle)
Patients with significant growth remaining (Risser 0-2 typically)
Adolescent idiopathic scoliosis or juvenile patterns
Motivated patients and families committed to wear compliance

Multidisciplinary Context

Scoliosis care often involves collaboration between:

Orthopaedic consultants or spinal specialists
Physiotherapists with scoliosis-specific training
Orthotists for brace design and fitting
Radiographers for imaging

We work as part of this team, not as a standalone solution.

Trusted Physiotherapy Partners

We work closely with specialist physiotherapists who understand scoliosis-specific exercise and rehabilitation:

Align Pilates & Physiotherapy

Specialist physiotherapy services with expertise in musculoskeletal care and rehabilitation.

Visit Align Pilates & Physiotherapy →

Niamh McGowan Physio

Experienced physiotherapy practice providing comprehensive assessment and treatment.

Visit McGowan Physio →

Belfast Pilates and Physiotherapy

Expert physiotherapy and Pilates services specialising in postural correction and rehabilitation.

Visit Belfast Pilates and Physiotherapy →

Frequently Asked Questions

We've answered common questions below. For specific concerns about your situation, please get in touch — we're here to help.

How many hours per day will my child need to wear the brace?+

Can my child still play sports and do physical activities?+

What is a Rigo (RSC®) brace?+

A Rigo brace (often called Rigo‑Chêneau or RSC®) is a rigid, custom‑made trunk brace designed to act in three dimensions on the spine and ribcage, using pressure zones and expansion areas to guide the spine toward a more corrected position. The Neja scolio RSC® brace is one of these systems and is produced in Germany using digital scanning and computer‑aided design and manufacturing.

The brace is usually used for children and teenagers with adolescent idiopathic scoliosis who are still growing and whose curves fall within certain size ranges (often roughly 20–45 degrees), in line with international bracing criteria such as those used by SOSORT and the Scoliosis Research Society.

Is the brace custom-made for my child?+

Will my child experience discomfort while wearing the brace?+

How often will follow-up appointments be needed?+

How can we care for my child's skin while wearing the brace?+

How long will my child need to wear the brace?+

Is the brace covered by insurance?+

What happens if my child outgrows the brace?+

Can my child sleep while wearing the brace?+

How do we maintain hygiene while wearing the brace?+

Will the brace affect my child's ability to attend school?+

How can we support my child's emotional well-being while wearing the brace?+

Is physical therapy recommended while wearing the brace?+

Are there any travel considerations while my child is wearing the brace?+

Are there different types of Rigo Chêneau braces?+

How do we care for and maintain the brace?+

Does bracing actually work?+

Evidence from high‑quality studies and meta‑analyses shows that bracing significantly increases the chance of preventing curve worsening and avoiding surgery in growing children with idiopathic scoliosis, compared with observation alone. Studies of Chêneau‑type and Rigo‑Chêneau braces suggest that these 3‑D asymmetric designs can achieve good curve control and, in some series, better end‑results than more traditional symmetric braces when properly prescribed and worn as recommended.

Guidelines from SOSORT emphasise that bracing should be part of a comprehensive conservative programme including education, regular follow‑up, and, where possible, specific scoliosis exercises, rather than being used in isolation.

How is a Neja Rigo brace made?+

The orthotist usually takes a 3‑D body scan or detailed measurements, along with your child's X‑rays and clinical assessment, to plan the brace design according to the Rigo principles for that particular curve pattern. Neja then uses CAD/CAM technology to manufacture a custom brace shell with carefully positioned pads and relief areas, aiming for strong correction but also comfort and freedom to breathe.

After the brace arrives, it is fitted and adjusted locally; your child will have a \"try‑on\" session where pressure points, strap positions and edges are fine‑tuned, and follow‑up appointments are used to refine the fit as your child grows.

Who makes the Neja Rigo brace?+

When is bracing recommended?+

Bracing is generally considered when a child or teenager is still growing (skeletally immature) and has a moderate curve that has a realistic risk of progression, especially during growth spurts. Many services follow criteria similar to those used in major brace studies: age around 10 or older, curves roughly 25–45 degrees, and visible growth remaining, although UK and local protocols may vary slightly.

In the UK, NHS guidance notes that braces are mainly used for children and adolescents with smaller to moderate curves who are still growing, with the aim of preventing progression rather than fully straightening the spine.

Will a brace straighten the spine permanently?+

The main goal of bracing is to stop or significantly slow curve progression while the child is growing, not to \"cure\" scoliosis or guarantee a perfectly straight spine. In‑brace X‑rays may show a visible improvement in Cobb angle, but once the brace is removed at the end of growth, some \"settling back\" is expected; success is usually defined as avoiding progression beyond key thresholds and reducing the likelihood of needing surgery.

Long‑term follow‑up studies of Rigo‑Chêneau and other Chêneau‑type braces show that many patients maintain stable curves into adulthood when treatment is started at the right time, fitted correctly and worn as prescribed.

What is the adjustment period like for my child when they first start wearing the brace?+

The adjustment period can vary for each child, but generally, it takes a few days to a couple of weeks for them to get used to wearing the brace. During this time, they may experience some discomfort or pressure points, which we will address through adjustments and support. We recommend gradually increasing wear time as tolerated and maintaining open communication with our team to ensure a smooth transition.

How can we help our child cope with the psychological impact of wearing a brace?+

Will the brace interfere with my child's school activities or social life?+

Will my child still be able to do sports and normal activities?+

Most children can continue school, hobbies and non‑contact sports while wearing a brace, and not interfere with most everyday activities. The brace is usually removed for PE that involves heavy contact, and some teams encourage certain sports and exercises (including scoliosis‑specific exercise approaches) to support posture, strength and wellbeing.

Open communication with school staff about the brace, PE exemptions where necessary, and practical things like locker access and rest breaks can make day‑to‑day life easier.

Are there any long-term effects of wearing a scoliosis brace?+

When used as prescribed, scoliosis braces like the Rigo Chêneau are generally safe and effective. Long-term studies indicate that many patients maintain stable curves into adulthood. However, it's important to monitor for any potential skin irritation or discomfort, which can usually be managed with proper care and adjustments. Regular follow-up appointments will help ensure the brace continues to fit well and function effectively.

How visible is the brace under clothing?+

What materials are used to make the Rigo Chêneau brace?+

Is the brace painful or uncomfortable?+

Pressure over certain areas is normal because the brace is designed to guide the spine; children often describe an initial feeling of tightness or constraint, especially in the first weeks. It should not cause sharp pain, skin breakdown or breathing difficulty; if it does, parents should contact the orthotist or clinic promptly to adjust the fit.

Skin can become warm and slightly red under pressure areas at first, but this usually settles; wearing a seam‑free brace vest, checking the skin daily, and slowly building up wear time can help your child adapt.

How often will my child need appointments and new braces?+

Children in braces are typically reviewed every few months to check curve behaviour, growth, brace fit and wear time, and to make adjustments. As your child grows, the brace may need replacement more than once; growth spurts are a common time to reassess and sometimes remeasure or rescan for a new brace.

Families should expect a combination of orthotics appointments, medical or surgical team reviews, and, in some centres, physiotherapy visits.

How long will my child need to wear the brace overall?+

Bracing usually continues until your child is close to skeletal maturity, which may be guided by growth charts, bone age and markers such as the Risser sign or menarche in girls. Many children wear a brace for several years, though the exact duration depends on when treatment starts, the rate of growth and how the curve behaves over time.

Near the end of growth, teams often reduce wear time gradually to test stability before stopping completely, while monitoring with repeat X‑rays.

Are there alternatives to bracing for scoliosis treatment?+

Yes, alternatives to bracing include observation for mild curves, scoliosis-specific exercises, and in some cases, surgical intervention for severe curves. The choice of treatment depends on various factors such as the severity of the curve, the age and growth potential of the child, and overall health. We will discuss all available options with you to determine the best course of action for your child's specific situation.

What is the success rate of bracing for scoliosis?+

Will my child definitely avoid surgery with a brace?+

Bracing greatly improves the odds of avoiding or delaying surgery for appropriately selected patients who wear their brace as prescribed, but it cannot guarantee that surgery will never be needed. Factors such as starting curve size, curve type, growth remaining and actual wear time all influence the final outcome; some children will still progress despite optimal conservative care.

If curves progress beyond certain thresholds (often around 45–50 degrees in growing teenagers), spinal surgeons may still advise surgery, but effective bracing can reduce how many children reach that point.

How is brace wear time monitored?+

Are there resources available for psychological support while my child is wearing a brace?+

How does a Rigo (RSC®) brace differ from other braces?+

Rigo‑system Chêneau braces are asymmetric and three‑dimensional, with specific pressure and expansion zones based on a classification of curve patterns, rather than a more symmetric \"tube‑like\" design. This design aims for stronger in‑brace correction of the spine and ribcage while still allowing lung expansion and more natural posture.

Evidence summarised in recent reviews suggests that Chêneau‑type and Rigo‑Chêneau braces can achieve high rates of treatment success and, in some comparative work, better outcomes than some older brace types, provided they are made and adjusted by trained teams.

Are Rigo/Neja braces recognised by guidelines like SOSORT?+

SOSORT guidelines do not endorse individual manufacturers but do support the use of modern rigid, custom, three‑dimensional braces that follow recognised biomechanical principles, delivered within specialised multidisciplinary services. Rigo‑system Chêneau braces, including Neja's RSC® brace, fit within this category of evidence‑based, pattern‑specific, rigid bracing when used in line with established criteria.

The guidelines emphasise that brace effectiveness depends more on appropriate indications, quality of design and fabrication, proper fitting, and adherence than on brand alone, so local team experience is crucial. [1] Negrini S, et al. 2018 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.

What are some tips to help my child comply with brace wear?+

To help your child comply with brace wear, consider the following tips:

1. Involve your child in the decision-making process and explain the benefits of wearing the brace

2. Set a consistent daily routine for putting on and taking off the brace

3. Use positive reinforcement and celebrate milestones

4. Connect with support groups or other families for encouragement

5. Communicate openly about any discomfort or concerns to make necessary adjustments

6. Encourage your child to express their feelings and provide emotional support throughout the treatment process.

What role do exercises play alongside the brace?+

SOSORT recommends that, where possible, scoliosis‑specific exercises (such as SEAS or PSSE approaches) be combined with brace treatment to support posture, muscle balance and coping, although high‑quality evidence is still developing. These exercises are usually taught by therapists trained in scoliosis methods and are tailored to your child's curve pattern and brace type.

Even simple general activities like walking, swimming and core‑strengthening exercises are usually encouraged to maintain fitness and wellbeing, provided the care team agrees.

What factors predict Rigo brace success versus failure?+

Rigo (RSC®/Chêneau‑type) brace success is most strongly predicted by how well the curve corrects on the first in‑brace X‑ray, the child's growth stage, the starting curve size and pattern, and how consistently the brace is worn. Failure is more likely when there is poor in‑brace correction, very early or very rapid growth with a lot of growth remaining, larger starting curves, and low adherence.

## Key predictors of success

- **Strong initial in‑brace correction**: Studies of Chêneau and Rigo‑system Chêneau braces show that the percentage correction seen on the first in‑brace X‑ray is the single strongest predictor of final outcome; better early correction is linked with smaller final curves and a higher chance of avoiding progression. One study reported a clear correlation between higher in‑brace correction and successful treatment, identifying this as the most valid single predictive parameter.

- **Favourable growth stage (Risser, menarche)**: Children who start bracing slightly later in growth (for example with a higher Risser sign and closer to or just after menarche in girls) tend to have more stable outcomes than those who begin at very early skeletal stages with a long period of rapid growth ahead. Very immature patients (Risser 0 with open growth plates) are at higher risk of progression despite bracing, so they require very close monitoring.

- **Good adherence (hours per day)**: For Rigo‑system Chêneau and other modern braces, wearing time close to the prescribed hours (often 18–23 hours per day) is consistently associated with higher success rates, whereas low wear times are associated with failure or surgery. Complete conservative programmes that follow SOSORT criteria and support families to maintain high adherence report low rates of progression to surgery.

## Curve‑related and technical factors

- **Starting curve size and pattern**: Mild to moderate curves (often in the 20–35° range) generally respond better than larger curves approaching surgical thresholds at the start of treatment. Some evidence suggests that thoracolumbar or lumbar single curves respond more favourably in terms of in‑brace correction than certain double major patterns, although results with Rigo‑type bracing can still be good across patterns when classification and brace design are accurate.

- **Quality of brace design and fitting**: SOSORT consensus papers emphasise that the technical quality of the brace (correct pad placement, 3‑D correction strategy, adequate expansion areas) and the expertise of the team are critical to outcome. In Rigo‑system Chêneau series, higher success rates are reported when braces are produced and adjusted in specialised centres using established protocols.

## Factors associated with failure or progression

- **Poor initial in‑brace correction**: If the first in‑brace X‑ray shows only minimal reduction of the Cobb angle, the risk of later progression is substantially higher; some authors regard insufficient correction as a warning sign that the brace design, fit or indication should be reconsidered.

- **Very early, rapid growth with large curves**: Children who are very skeletally immature with substantial growth remaining and relatively larger curves at the start are more likely to progress to surgical ranges despite bracing, especially if growth is very rapid.[5][2]

- **Low wear time and poor follow‑up**: Inadequate daily wear, infrequent adjustments during growth, or pauses in treatment reduce the protective effect of the brace and are associated with higher rates of progression and surgery. Programmes that do not follow structured SOSORT‑style protocols for education, monitoring and brace optimisation tend to report more variable and sometimes poorer outcomes.

What to Expect

Treatment Timeline

From initial assessment to receiving your brace typically takes 2-4 weeks. This includes time for fabrication and quality checks. Adjustments and modifications are common, especially during the initial fitting phase.

Living with a Brace

There's an adjustment period as your child gets used to wearing the brace:

First week: Gradual increase in wear time, skin monitoring
First month: Building tolerance, minor adjustments common
Ongoing: Regular check-ups, growth-related modifications

Practical Tips

Wear a smooth, fitted vest or t-shirt under the brace
Check skin daily for any red marks or pressure areas
Follow the prescribed wearing schedule consistently
Maintain open communication with your care team
Join support groups or connect with other families

Activities and School

Most daily activities can continue with modifications. PE lessons, swimming (during brace-free time), and social activities are encouraged. We provide guidance for schools and activity leaders as needed.

Brace Fitting Process

Patient during brace fitting consultation — Personalized fitting and adjustment

Professional brace fitting session — Expert guidance throughout

Patient wearing fitted Neja brace — Comfortable and effective support

20+

Years Experience

100%

HCPC Registered

Custom

Brace Design

Patient and Family Experiences

Hear from families who've been through the bracing journey. All testimonials are anonymised and shared with consent.

Thank you so much, because the thoughtful and pay attention to all of my problem, even the very nice kindness messages that you sent, the first time that you didn't even know me for all you show it means more than you would ever know.

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Investment and Funding

We operate as a private clinic, and costs vary based on individual needs, brace complexity, and follow-up requirements.

Typical Components

Initial assessment and consultation
3D scanning or casting
Custom brace fabrication
Fitting appointment and adjustments
Follow-up reviews and modifications

For specific pricing and potential funding pathways, please contact us directly. We're transparent about costs and happy to discuss payment options.

Get Started

Ready to discuss scoliosis bracing?

Contact us to arrange an initial consultation. We'll review your child's situation, answer your questions, and explain the next steps if bracing is appropriate.

📍 Location

56 Holywood Road
Belfast, BT4 1NT

We aim to respond to all enquiries within 24 hours (weekdays).

Your personal information is handled in accordance with GDPR and our privacy policy. We'll only use your details to respond to your enquiry.

For Referring Clinicians

We accept referrals from orthopaedic consultants, GPs, physiotherapists, and other healthcare professionals, as well as direct family contact.

Referral Information

Helpful Documentation

Recent X-rays (standing PA and lateral preferred)
Cobb angle measurements and curve classification
Risser sign or skeletal maturity assessment
Previous treatment history
Any clinical notes or recommendations

Assessment Process

Comprehensive postural and clinical evaluation
Discussion of treatment goals and expectations
Brace design planning based on curve pattern
3D scanning or casting as appropriate
Family education and consent

For referral or to discuss a case, please contact us at info@bullorthotics.com

Ready to Get Started?

Request Assessment