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

  • Biomechanics
  • Published:
Spine Deformity Aims and scope Submit manuscript

Abstract

Study design

Retrospective validation study.

Objectives

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 (3D) geometries of 10 patients before and during conservative treatment were reconstructed from biplanar 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’ 3D 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 5.6°. 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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Authors and Affiliations

  1. Arts et Metiers ParisTech, LBM, 151 bd de l’Hopital, 75013, Paris, France

    Claudio Vergari PhD, Gwenael Ribes MEng, Benjamin Aubert MEng, Clayton Adam PhD, Philippe Rouch PhD & Wafa Skalli PhD

  2. Department of Pediatric Orthopedics, Necker Enfants Malades Hospital, AP-HP, 149 rue de Sevres, 75743, Paris Cedex 15, France

    Lotfi Miladi MD

  3. Pediatric Orthopaedics Department, Robert Debré Hospital, AP-HP, Paris Diderot University, 48 Bd Sℰurier, 75019, Paris, France

    Brice Ilharreborde MD

  4. Department of Pediatric Orthopedics, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France

    Kariman Abelin-Genevois MD

Authors
  1. Claudio Vergari PhD
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  2. Gwenael Ribes MEng
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  3. Benjamin Aubert MEng
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  4. Clayton Adam PhD
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  5. Lotfi Miladi MD
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  6. Brice Ilharreborde MD
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  7. Kariman Abelin-Genevois MD
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  8. Philippe Rouch PhD
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  9. Wafa Skalli PhD
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Corresponding author

Correspondence to Claudio Vergari PhD.

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Vergari, C., Ribes, G., Aubert, B. et al. Evaluation of a Patient-Specific Finite-Element Model to Simulate Conservative Treatment in Adolescent Idiopathic Scoliosis. Spine Deform 3, 4–11 (2015). https://doi.org/10.1016/j.jspd.2014.06.014

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  • DOI: https://doi.org/10.1016/j.jspd.2014.06.014

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