Aubin C E, Dansereau J, de Guise J A, Labelle H
Department of Mechanical Engineering, Ecole Polytechnique, Montréal, Québec, Canada.
Spine (Phila Pa 1976). 1997 Mar 15;22(6):629-35. doi: 10.1097/00007632-199703150-00010.
The three-dimensional (3-D) interrelations in the correction of the spine and rib cage produced by the Boston brace were analyzed in a group of adolescents with idiopathic scoliosis.
To investigate the coupling movements between the spine and rib cage initiated by brace wear (i.e., the displacements of the spine that take place in other directions than the ones generated by brace pressures on the thorax).
The effects of thoraco-lumbo-sacral orthosis in the frontal plane have been well documented, but they have never been studied in terms of 3-D coupled movements between the spine and rib cage.
The spine and rib cage of 36 adolescents with idiopathic scoliosis with and without their Boston brace were reconstructed in 3-D using a stereo-radiographic technique. Several geometric indices were evaluated on the trunk, and the relative motions of the spine and rib cage resulting from brace wearing were compared by means of Student t tests, Pearson correlation matrices, and linear regressions.
Rib cage transverse plane translations resulting from brace pressures are related to those of the spine. Coupled movements between the spine and rib cage were found to alter substantially the expected 3-D correction of the trunk. Significant anterior displacements of the thorax were observed and were statistically associated with lateral displacements of the spine and with an increase of spinal thoracic curvatures in the frontal and sagittal planes.
Brace loads are not applied in an optimal way to correct the 3-D deformities associated with thoracic idiopathic scoliosis. Loads applied on the posterior rib hump should be reequilibrated to reduce anterior displacement of the trunk.
在一组特发性脊柱侧弯青少年患者中，分析了波士顿支具对脊柱和胸廓矫正的三维（3-D）相互关系。
研究佩戴支具引发的脊柱与胸廓之间的耦合运动（即脊柱在支具对胸廓施加压力产生的方向以外的其他方向上的位移）。
胸腰骶矫形器在额状面的作用已有充分记录，但从未从脊柱与胸廓之间的三维耦合运动方面进行研究。
采用立体放射照相技术对36例佩戴和未佩戴波士顿支具的特发性脊柱侧弯青少年患者的脊柱和胸廓进行三维重建。对躯干评估了几个几何指标，并通过学生t检验、皮尔逊相关矩阵和线性回归比较了佩戴支具后脊柱和胸廓的相对运动。
支具压力导致的胸廓横平面平移与脊柱的平移相关。发现脊柱与胸廓之间的耦合运动显著改变了躯干预期的三维矫正。观察到胸廓有明显的向前位移，且在统计学上与脊柱的侧向位移以及额状面和矢状面脊柱胸段曲度增加相关。
支具施加的负荷并非以最佳方式用于矫正与胸段特发性脊柱侧弯相关的三维畸形。应重新平衡施加在肋骨后凸上的负荷，以减少躯干的向前位移。
