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Prediction of brace effect in scoliotic patients: blinded evaluation of a novel brace simulator—an observational cross-sectional study

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Abstract

Purpose

Bracing is the most commonly used treatment for scoliosis. But braces remain predominantly “handcrafted.” Our objective was to create a novel brace simulator using a high-fidelity 3D “avatar” of the patient’s trunk.

Methods

An observational cross-sectional study was constructed. The inclusion criteria were patients with a moderate idiopathic scoliosis (between 15° and 35° of Cobb angle) aged between 9 and 15 years old with an indication of brace treatment. Twenty-nine scoliotic patients, 25 girls and four boys, with a mean age of 12.4 years were included. Twenty right thoracic and 14 left lumbar were measured with a mean Cobb angle of 24°. 3D “avatars” were generated using a novel technology called the “anatomy transfer.” Biomedical simulations were conducted by engineers who were blinded to the clinical effect of the real patient brace. The in-brace Cobb angle effect (real effect) was compared with the virtual numeric in-brace Cobb angle observed using the blindly constructed avatar (simulation effect).

Results

Real and simulated in-brace Cobb angle were compared using a paired two-sided Student’s t test. The real mean Cobb angle was 11° and 17° in the simulation which was statistically significant. The strength of prediction of the simulation was assessed for each individual patient; 76% of the real in-brace Cobb angles had good and moderate prediction (± 10°).

Conclusions

Incorporating high-fidelity copy of the entire 3D shape of the patient’s trunk and multiple 3D-reconstructed bony images into an anatomical reference avatar resulted in moderate-to-good prediction of brace effect in three quarters of patients.

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Acknowledgements

We acknowledge Dr Kelly Dilworth for the manuscript English review.

Funding

Grenoble Alps University Hospital Innovation Grant 2015.

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Authors and Affiliations

  1. Grenoble Alps Scoliosis and Spine Center-Grenoble Alps University Hospital. SPM-TIMC-IMAG, BP 217, Grenoble Cedex 09, France

    Aurélien Courvoisier

  2. Anatoscope-Cap-Omega Rond-Point Benjamin Franklin, 34960, Montpellier, France

    Matthieu Nesme & François Faure

  3. Demeure Orthopédie, 1 Rue Rosa Lee Parks, 38400, Saint-Martin-d’Hères, France

    Julien Gerbelot

  4. CIC-IT, TIMC-IMAG, 5 Avenue Du Grand Sablon, 38700, La Tronche, France

    Alexandre Moreau-Gaudry

Authors
  1. Aurélien Courvoisier
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  2. Matthieu Nesme
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  3. Julien Gerbelot
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  4. Alexandre Moreau-Gaudry
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  5. François Faure
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Correspondence to Aurélien Courvoisier.

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Courvoisier, A., Nesme, M., Gerbelot, J. et al. Prediction of brace effect in scoliotic patients: blinded evaluation of a novel brace simulator—an observational cross-sectional study. Eur Spine J 28, 1277–1285 (2019). https://doi.org/10.1007/s00586-019-05948-9

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  • DOI: https://doi.org/10.1007/s00586-019-05948-9

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