Towards a predictive simulation of brace action in adolescent idiopathic scoliosis

Abstract

Bracing is the most common treatment to stop the progression of adolescent idiopathic scoliosis. Finite element modeling could help improve brace design, but model validation is still a challenge. In this work, the clinical relevance of a predictive and subject-specific model for bracing was evaluated in forty-six AIS patients. The model reproduces brace action and the patient’s spinopelvic adjustments to keep balance. The model simulated 70% or more patients with geometrical parameters within a preselected tolerance level. Although the model simulation of the sagittal plane could be improved, the approach is promising for a realistic and predictive simulation of brace action.

Keywords:

• Spine deformity
• orthosis
• finite element modelling
• biomechanics

Acknowledgments

The authors are grateful to the ParisTech BiomecAM chair program on subject-specific musculoskeletal modelling (with the support of ParisTech and Yves Cotrel Foundations, Proteor, Société Générale and Covea). We are also thankful to David Barrie Colridge for his support.

Disclosure statement

Dr. Skalli has a patent related to biplanar X-Rays and associated 3 D reconstruction methods, with no personal financial benefit (royalties rewarded for research and education) licensed to EOS Imaging. Dr. Vialle reports personal fees and grants (unrelated to this study) from EOS Imaging. This study was partly funded by the company Proteor.

Ethics approval

The data collection was approved of by the ethical committee (CPP 6001 Ile de France V), and patients and their parents signed an informed consent.