Gignac D, Aubin C E, Dansereau J, Poulin F, Labelle H
Hôpital Sainte-Justine, Centre de Recherche, Montréal, Québec, Canada.
Ann Chir. 1998;52(8):795-800.
Scoliosis is a complex deformity of the spine and rib cage often treated by the Boston brace. The goal of this research is to study the simulation of two new treatment approaches and to compare their results to the Boston brace. A personalized biomechanical model has been used to simulate the treatment on 20 scoliotic teenagers with double curvature. On the first treatment, different forces were applied at the thoracic apex level and the posterior displacement of the rib hump was locked. For the second treatment, an oblique force oriented 45 degrees with respect to the frontal plane was added at the lumbar apex. Following each simulation, geometrical and clinical measurements were calculated and compared to the initial geometry and the Boston brace treatment. Overall, the two new treatment modalities correct the thoracic Cobb angle in the frontal plane while maintaining the normal physiological curvatures in the sagittal plane, move the thoracic plane of maximum deformity towards the sagittal plane and reduce axial rotation and rib hump. In comparison, the Boston brace reduces the Cobb angles in the frontal as well as in the sagittal planes, moves the planes of maximum deformities towards the coronal plane and has no effect on axial rotation and rib hump. This biomechanical study shows force patterns that correct scoliosis more efficiently than the Boston brace. These new treatment approaches must be personalized for each patient and still require clinical evaluation.
脊柱侧弯是一种复杂的脊柱和胸廓畸形，通常采用波士顿支具进行治疗。本研究的目的是研究两种新治疗方法的模拟效果，并将其结果与波士顿支具进行比较。已使用个性化生物力学模型对20名双弯型脊柱侧弯青少年进行治疗模拟。在第一种治疗中，在胸段顶点水平施加不同的力，并锁定肋骨隆起的后移。在第二种治疗中，在腰段顶点增加一个相对于额平面成45度角的斜向力。每次模拟后，计算几何和临床测量值，并与初始几何形状和波士顿支具治疗进行比较。总体而言，这两种新治疗方式在额平面上矫正胸段Cobb角，同时在矢状面保持正常生理曲度，将最大畸形的胸段平面移向矢状面，并减少轴向旋转和肋骨隆起。相比之下，波士顿支具在额平面和矢状面都减小了Cobb角，将最大畸形平面移向冠状面，并且对轴向旋转和肋骨隆起没有影响。这项生物力学研究显示了比波士顿支具更有效地矫正脊柱侧弯的力模式。这些新治疗方法必须针对每个患者进行个性化定制，并且仍需要临床评估。
