Plaster can be wrapped around a trunk in order to immobilise a deviated spine in the correct position. The aim is to exploit the considerable pressure exerted by this rigid material on the protruding or non-homogeneous parts of the trunk, so as to obtain a definite correction. The rationale is to ensure, immediately, a big improvement and then to control the trunk through rigid braces.
This is, in fact, what seems to happen. If you look at an X-ray taken immediately after the application of a plaster cast, you will probably be amazed by the result, as the image will usually show remarkably gentle curves in place of the tight ones that were visible on the X-ray taken before the cast was applied.
However, once the plaster cast is removed, the spine will tend to revert to its starting condition, although this collapse is, to an extent, controlled by the rigid brace the patient is given to wear immediately afterwards. Overall, what this means, at the end of the day, is that the improvement obtained with a plaster cast is far less marked that it initially seemed to be.
Ever since 2004 we at Isico have been developing and using the Sforzesco brace, which has been shown to be as effective as plaster casting (if not more so, because its effect is more progressive, and therefore it is able to go on correcting over time); furthermore, it has fewer side effects, is clearly less obtrusive and therefore aesthetically less problematic, and it allows the patient wearing it to continue with his/her normal daily activities. In our view, the main advantages of this treatment are related to the individual’s quality of life: in short, if you want to consider your patients’ psychological wellbeing as well as just their back; if you are concerned about the future functionality of the spine in addition to its anatomical correctness; and if, rather than just prescribing braces, you want to find ways of helping your patients to wear them, then you clearly have far more reasons to abandon plaster casts rather than to go on prescribing them.
Studies published in prestigious international scientific journals have demonstrated the superior results obtained with the Sforzesco brace.