Grenoble Alps Scoliosis and Spine Center-Grenoble Alps University Hospital. SPM-TIMC-IMAG, BP 217, Grenoble Cedex 09, France.
Anatoscope-Cap-Omega Rond-Point Benjamin Franklin, 34960, Montpellier, France.
Eur Spine J. 2019 Jun;28(6):1277-1285. doi: 10.1007/s00586-019-05948-9. Epub 2019 Mar 16.
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.
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).
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°).
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. These slides can be retrieved under Electronic Supplementary Material.
支具矫形是治疗脊柱侧凸最常用的方法。但支具仍然主要是“手工制作”的。我们的目标是利用患者躯干的高保真 3D“化身”创建一种新型的支具模拟器。
构建了一项观察性横断面研究。纳入标准为年龄在 9 至 15 岁之间、具有支具治疗指征的中度特发性脊柱侧凸（Cobb 角在 15°至 35°之间）患者。共纳入 29 例脊柱侧凸患者，25 名女性和 4 名男性，平均年龄 12.4 岁。20 例为右侧胸弯，14 例为左侧腰弯，平均 Cobb 角为 24°。使用一种称为“解剖转移”的新技术生成 3D“化身”。由对真实患者支具临床效果一无所知的工程师进行生物医学模拟。将支具内 Cobb 角的实际效果（真实效果）与使用盲法构建的化身（模拟效果）观察到的虚拟数值支具内 Cobb 角进行比较。
采用双侧配对学生 t 检验比较真实和模拟支具内 Cobb 角。真实平均 Cobb 角为 11°，模拟为 17°，差异具有统计学意义。对每个患者进行模拟预测强度评估；76%的真实支具内 Cobb 角具有良好和中度预测（±10°）。
将患者躯干的整个 3D 形状和多个 3D 重建的骨性图像的高保真副本纳入解剖参考化身中，可使四分之三的患者支具效果的预测达到中等至良好的程度。这些幻灯片可以在电子补充材料中检索。
