Boston Brace Correction in Idiopathic Scoliosis: A Biomechanical Study

Périé, Delphine; Aubin, Carl‐Éric; Petit, Yvan; Beauséjour, Marie; Dansereau, J.; Labelle, Hubert

doi:10.1097/01.brs.0000083165.93936.6d

Cited by 43 publications

(12 citation statements)

References 19 publications

(22 reference statements)

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“…Previous modeling works evaluated the thoracic region focusing on corrective treatments of scoliosis (Grealou et al, 2002; Aubin et al, 2003; Perie et al, 2003; Duke et al, 2005; Salmingo et al, 2012; Curtin and Lowery, 2014). Furthermore, spine models developed for load estimation were mostly oriented to explore lumbar region, describing thorax as a single rigid body (Stokes and Gardner-Morse, 1995; Shirazi-Adl et al, 2005; de Zee et al, 2007; Arjmand et al, 2009; Christophy et al, 2012; Han et al, 2012; Ghezelbash et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Semiautomated 3D Spine Reconstruction from Biplanar Radiographic Images: Prediction of Intervertebral Loading in Scoliotic Subjects

Bassani

Ottardi

Costa

et al. 2017

Front. Bioeng. Biotechnol.

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The present study proposes a semiautomatic software approach to reconstruct 3D subject-specific musculoskeletal model of thoracolumbar spine from radiographic digitized images acquired with EOS system. The approach is applied to evaluate the intervertebral loads in 38 standing adolescents with mild idiopathic scoliosis. For each vertebra, a set of landmarks was manually identified on radiographic images. The landmark coordinates were processed to calculate the following vertebral geometrical properties in the 3D space (i) location (ii) dimensions; and (iii) rotations. Spherical joints simulated disks, ligaments, and facet joints. Body weight distribution, muscles forces, and insertion points were placed according to physiological–anatomical values. Inverse static analysis, calculating joints’ reactions in maintaining assigned spine configuration, was performed with AnyBody software. Reaction forces were computed to quantify intervertebral loads, and correlation with the patient anatomical parameters was then checked. Preliminary validation was performed comparing the model outcomes with that obtained from other authors in previous modeling works and from in vivo measurements. The comparison with previous modeling works and in vivo studies partially fulfilled the preliminary validation purpose. However, minor incongruities were pointed out that need further investigations. The subjects’ intervertebral loads were found significantly correlated with the anatomical parameters in the sagittal and axial planes. Despite preliminary encouraging results that support model suitability, future investigations to consolidate the proposed approach are necessary. Nonetheless, the present method appears to be a promising tool that once fully validated could allow the subject-specific non-invasive evaluation of a deformed spine, providing supplementary information to the routine clinical examination and surgical intervention planning.

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Section: Introductionmentioning

confidence: 99%

Semiautomated 3D Spine Reconstruction from Biplanar Radiographic Images: Prediction of Intervertebral Loading in Scoliotic Subjects

Bassani

Ottardi

Costa

et al. 2017

Front. Bioeng. Biotechnol.

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“…A biomechanical study by Perie et al [41] has evaluated the effectiveness of the Boston brace using finite element model and experimental measurements. It highlighted the contribution of bracing pads to curve reduction but also suggested that other mechanisms participated in orthotic correction.…”

Section: Methods Developed To Assist Bracing Treatmentmentioning

confidence: 99%

Computer algorithms and applications used to assist the evaluation and treatment of adolescent idiopathic scoliosis: a review of published articles 2000–2009

et al. 2011

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Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity whose assessment and treatment present many challenges. Computer applications have been developed to assist clinicians. A literature review on computer applications used in AIS evaluation and treatment has been undertaken. The algorithms used, their accuracy and clinical usability were analyzed. Computer applications have been used to create new classifications for AIS based on 2D and 3D features, assess scoliosis severity or risk of progression and assist bracing and surgical treatment. It was found that classification accuracy could be improved using computer algorithms that AIS patient follow-up and screening could be done using surface topography thereby limiting radiation and that bracing and surgical treatment could be optimized using simulations. Yet few computer applications are routinely used in clinics. With the development of 3D imaging and databases, huge amounts of clinical and geometrical data need to be taken into consideration when researching and managing AIS. Computer applications based on advanced algorithms will be able to handle tasks that could otherwise not be done which can possibly improve AIS patients' management. Clinically oriented applications and evidence that they can improve current care will be required for their integration in the clinical setting.

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“…Brace manufacturing has been transformed by computer-assisted modelling and manufacture by using 3D laser scanners to obtain patient torso data and directly carve out a mould for a brace [23,24]. For fitting braces, finite element computer models have been developed that may analytically test multiple types of braces to determine the optimal amount of force and pad placement within the brace [25][26][27][28][29][30][31][32][33]. Ultrasound has also been used to evaluate curve correction while patients are in a brace to check the efficacy of a brace in real time [34,35].…”

Section: Guidelines For Bracing Studiesmentioning

confidence: 99%

Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis

Chan

Lou

Hill

2013

Journal of Children's Orthopaedics

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Purpose To report on the current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis. Methods A comprehensive literature review was performed to determine the effectiveness of bracing, to report on imaging techniques that can assist in the assessment of bracing, to understand the roles of the biomechanical treatment concepts on bracing and to address the importance of the quality of life of the brace wearers. Results The effectiveness of bracing still remains controversial. Many technologies are still in development to improve the bracing process and quantify the effects of bracing. Imaging techniques with decreased or no radiation are promising in providing more frequent data on curve progression for patients. Computer-assisted design models have been used for both fitting and manufacturing the brace to patient contours. Ultrasound has been developed as a new means of diagnosing scoliosis and determining the effects of a brace on a patient's spine in real time. The brace treatment outcomes are correlated to the quantity and the quality of brace usage. Compliance monitors and force sensors have been developed to track the quality of brace usage. Improvements to brace wear also require consideration of patient quality of life. Surveys have been developed to describe the effects of family influence and selfimage on bracing effectiveness of patient quality of life. Conclusions Bracing remains a highly qualitative process, relying on the empirical judgment of the physicians and orthotists, along with buy-in with the patient. The suggested improvements will help to push bracing into a more evidence-based practice.

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Boston Brace Correction in Idiopathic Scoliosis: A Biomechanical Study

Abstract: High thoracic pads reduced more effectively both thoracic and lumbar scoliotic curves than lumbar pads only. The study suggests that mechanisms other than brace pads produce correction and contribute to the force equilibrium within the brace.

Cited by 43 publications

References 19 publications

Semiautomated 3D Spine Reconstruction from Biplanar Radiographic Images: Prediction of Intervertebral Loading in Scoliotic Subjects

Semiautomated 3D Spine Reconstruction from Biplanar Radiographic Images: Prediction of Intervertebral Loading in Scoliotic Subjects

Computer algorithms and applications used to assist the evaluation and treatment of adolescent idiopathic scoliosis: a review of published articles 2000–2009

Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis

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