3D analysis of brace treatment in idiopathic scoliosis

Courvoisier, Aurélien; Drevelle, Xavier; Vialle, Raphaël; Dubousset, Jean; Skalli, Wafa

doi:10.1007/s00586-013-2881-7

Cited by 53 publications

(55 citation statements)

References 19 publications

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“…Seven (22%) of the patients were found to have thoracic flat back, but 3 of them had it before treatment. A previous study by Courvoisier et al 4 on the immediate correction provided by brace treatment showed significant decreases in LL but no statistical difference in TK. However, progressive modifications of the spine may occur throughout the treatment period.…”

Section: Discussionmentioning

confidence: 80%

“…A previous study found no statistically significant immediate modification of transverse plane parameters. 4 Lebel et al 11 compared the differences in immediate 3D effects between the Chêneau brace and the Boston brace by assessing 3D reconstructions. They demonstrated that the Chêneau brace had a significant de-rotation effect compared with the Boston brace.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Fang¹,

Wang²,

Xiang³

et al. 2015

SPI

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OBJECT The aim of the present study was to retrospectively evaluate progressive correction of coronal and sagittal alignment and pelvic parameters in patients treated with a Chêneau brace. METHODS Thirty-two patients with adolescent idiopathic scoliosis (AIS) were assessed before initiation of bracing treatment and at the final follow-up. Each patient underwent radiological examinations, and coronal, sagittal, and pelvic parameters were measured. RESULTS No statistically significant modification of the Cobb angle was noted. The pelvic incidence remained unchanged in 59% of the cases and increased in 28% of the cases. The sacral slope decreased in 34% of the cases but remained unchanged in 50%. Thoracic kyphosis and lumbar lordosis were significantly decreased, whereas the sagittal vertical axis was significantly increased from a mean of -44.0 to -30.2 mm (p = 0.02). The mean pelvic tilt increased significantly from 4.5° to 8.3° (p = 0.002). CONCLUSIONS The Chêneau brace can be useful for preventing curvature progression in patients with AIS. However, the results of this study reveal high variability in the effect of brace treatment on sagittal and pelvic alignment. Treatment with the Chêneau brace may also influence sagittal global balance.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Fang¹,

Wang²,

Xiang³

et al. 2015

SPI

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“…Recent advancements are now allowing true 3D assessment of scoliosis and are causing a fundamental shift in how we think about assessment, treatment, and prognosis. Work by Courvoisier et al has demonstrated that the EOS 3D radiography system (EOS Imaging) can be used to assess the efficacy of a brace-measuring correction of rotational deformity in addition to Cobb angle [10,11]. Courvoisier et al and Nault et al have used EOS to show that measures of transverse-plane deformity correlate strongly with progression [9,24,25].…”

Section: Predictor Variables Considered and Selectedmentioning

confidence: 96%

Predicting success or failure of brace treatment for adolescents with idiopathic scoliosis

Chalmers

Westover

Jacob

et al. 2015

Med Biol Eng Comput

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Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity. Brace treatment is a common non-surgical treatment, intended to prevent progression (worsening) of the condition during adolescence. Estimating a braced patient's risk of progression is an essential part of planning treatment, so method for predicting this risk would be a useful decision support tool for practitioners. This work attempts to discover whether failure of brace treatment (progression) can be predicted at the start of treatment. Records were obtained for 62 AIS patients who had completed brace treatment. Subjects were labeled as "progressive" if their condition had progressed despite brace treatment and "non-progressive" otherwise. Wrapper-based feature selection selected two useful predictor variables from a list of 14 clinical measurements taken from the records. A logistic regression model was trained to classify patients as "progressive" or "non-progressive" using these two variables. The logistic regression model's simplicity and interpretability should facilitate its clinical acceptance. The model was tested on data from an additional 28 patients and found to be 75 % accurate. This accuracy is sufficient to make the predictions clinically useful. It can be used online: http://www.ece.ualberta.ca/~dchalmer/SimpleBracePredictor.html .

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“…Low-dose bi-planar radiographs can be used in routine clinical practice to assess patient specific spinal geometry during conservative treatment, allowing better description of the correction in three dimensions [6]. Testing different brace designs in order to optimize correction, however, requires multiple radiographic images; radiation doses can then accumulate over the several years that are often needed for this treatment.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Patient-Specific Finite-Element Model to Simulate Conservative Treatment in Adolescent Idiopathic Scoliosis

et al. 2015

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Study design: Retrospective validation studyObjectives: To propose a method to evaluate, from a clinical standpoint, the ability of a finite element model (FEM) of the trunk to simulate orthotic correction of spinal deformity, and to apply it to validate a previously described FEM Summary of background data: Several FEMs of the scoliotic spine have been described in the literature. These models can prove useful in understanding the mechanisms of scoliosis progression and in optimizing its treatment, but their validation has often been lacking or incomplete.Methods: Three-dimensional geometries of ten patients before and during conservative treatment were reconstructed from bi-planar radiographs. The effect of bracing was simulated by modeling displacements induced by the brace pads. Simulated clinical indices (Cobb angle, T1-T12 and T4-T12 kyphosis, L1-L5 lordosis, apical vertebral rotation, torsion, rib hump) and vertebral orientations and positions were compared to those measured in the patients' three-dimensional geometries.Results: Errors in clinical indices were of the same order of magnitude as the uncertainties due to 3D reconstruction; for instance, Cobb angle was simulated with a root mean square error of 5.7° and rib hump error was 6.4°. Vertebral orientation was simulated with a root mean square error of 4.8° and vertebral position with an error of 2.5 mm. Conclusions:The methodology proposed here allowed in-depth evaluation of subject-specific simulations, confirming that FEMs of the trunk have the potential to accurately simulate brace action. These promising results provide a basis for ongoing 3D model development, toward the design of more efficient orthoses.

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3D analysis of brace treatment in idiopathic scoliosis

Cited by 53 publications

References 19 publications

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis

Predicting success or failure of brace treatment for adolescents with idiopathic scoliosis

Evaluation of a Patient-Specific Finite-Element Model to Simulate Conservative Treatment in Adolescent Idiopathic Scoliosis

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