Pediatric Orthopedic Surgery Department, Grenoble University Hospital, Joseph Fourier University, BP 217 38043 Cedex 09 Grenoble, France
Expert Rev Med Devices. 2014 Jan;11(1):1-3. doi: 10.1586/17434440.2014.848166. Epub 2013 Dec 18.
One of the major revolutions in the field of adolescent idiopathic scoliosis (AIS) during the past 10 years is the development of 3D imaging devices in standing position, such as EOS (EOS Imaging). 3D vision of the spine is new; we need to be humble and learn how it may help in the management of AIS. But we now have access to the transverse plane deformity. We do not know how to heal idiopathic scoliosis. Thus, the main issue in the field of AIS management is to avoid progression of mild scoliosis. Brace treatment is the main treatment option for mild scoliotic patients during growth. However, the efficacy of brace treatment is not consensual. We have demonstrated through a 3D analysis of brace treatment that some braces are truly efficient, some are not and others worsen the spinal deformity. Therefore, we have to anticipate the effect of a brace on a specific patient. With 3D analysis we are now able to evaluate if a brace really improves the spinal shape in the 3 dimensions or not. Moreover, we have the patient 3D geometry (spine and rib cage) and we are able to collect objective clinical data that could help achieve relevant parametric finite element models. These models could help in the prediction of brace effect but they need to be validated with clinical data. We see a close future where we will all have the 3D trunk shape of our patients on our screens along with all computed angles we need and then an instant prediction for the best-fit brace geometry for our patient.
在过去的 10 年中，青少年特发性脊柱侧凸（AIS）领域的主要变革之一是 3D 成像设备在站立位的发展，如 EOS（EOS Imaging）。脊柱的 3D 视野是新的；我们需要保持谦逊并学习它如何帮助 AIS 的管理。但是，我们现在可以获得横断平面的畸形。我们不知道如何治疗特发性脊柱侧凸。因此，AIS 管理领域的主要问题是避免轻度脊柱侧凸的进展。支具治疗是生长过程中轻度脊柱侧凸患者的主要治疗选择。然而，支具治疗的疗效并不一致。我们通过 3D 分析支具治疗证明，一些支具确实有效，一些则无效，还有一些会使脊柱畸形恶化。因此，我们必须预测支具对特定患者的效果。通过 3D 分析，我们现在能够评估支具是否真的能改善脊柱的三维形状。此外，我们拥有患者的 3D 几何形状（脊柱和胸廓），并且能够收集有助于实现相关参数有限元模型的客观临床数据。这些模型可以帮助预测支具的效果，但需要用临床数据进行验证。我们可以预见，在不久的将来，我们所有的屏幕上都将显示患者的 3D 躯干形状，以及我们需要的所有计算角度，然后可以立即预测出适合患者的最佳支具几何形状。
