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Effectiveness of braces designed using computer-aided design and manufacturing (CAD/CAM) and finite element simulation compared to CAD/CAM only for the conservative treatment of adolescent idiopathic scoliosis: a prospective randomized controlled trial

Nikita Cobetto, Carl-Éric Aubin, Stefan Parent, Julien Clin, Soraya Barchi, Isabelle Turgeon and Hubert Labelle

Article (2016)

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Cite this document: Cobetto, N., Aubin, C.-É., Parent, S., Clin, J., Barchi, S., Turgeon, I. & Labelle, H. (2016). Effectiveness of braces designed using computer-aided design and manufacturing (CAD/CAM) and finite element simulation compared to CAD/CAM only for the conservative treatment of adolescent idiopathic scoliosis: a prospective randomized controlled trial. European Spine Journal, 25(10), p. 3056-3064. doi:10.1007/s00586-016-4434-3
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Abstract

Purpose Clinical assessment of immediate in-brace effect of braces designed using CAD/CAM and FEM vs. only CAD/CAM for conservative treatment of AIS, using a randomized blinded and controlled study design. Methods Forty AIS patients were prospectively recruited and randomized into two groups. For 19 patients (control group), the brace was designed using a scan of patient’s torso and a conventional CAD/CAM approach (CtrlBrace). For the 21 other patients (test group), the brace was additionally designed using finite element modeling (FEM) and 3D reconstructions of spine, rib cage and pelvis (NewBrace). The NewBrace design was simulated and iteratively optimized to maximize the correction and minimize the contact surface and material. Results Both groups had comparable age, sex, weight, height, curve type and severity. Scoliosis Research Society standardized criteria for bracing were followed. Average Cobb angle prior to bracing was 27° and 28° for main thoracic (MT) and lumbar (L) curves, respectively, for the control group, while it was 33° and 28° for the test group. CtrlBraces reduced MT and L curves by 8° (29 %) and 10° (40 %), respectively, compared to 14° (43 %) and 13° (46 %) for NewBraces, which were simulated with a difference inferior to 5°. NewBraces were 50 % thinner and had 20 % less covering surface than CtrlBraces. Conclusion Braces designed with CAD/CAM and 3D FEM simulation were more efficient and lighter than standard CAD/CAM TLSO’s at first immediate in-brace evaluation. These results suggest that long-term effect of bracing in AIS may be improved using this new platform for brace fabrication.

Uncontrolled Keywords

Computer-aided design/computer-aided manufacturing; Scoliosis; Thoraco-lumbo-sacral orthosis; Finite element modeling (FEM); RCT

Open Access document in PolyPublie
Subjects: 2100 Génie mécanique > 2100 Génie mécanique
9000 Sciences médicales > 9000 Sciences médicales
Department: Département de génie mécanique
Research Center: Non applicable
Funders: CRSNG/NSERC, Canadian Institutes of Health Research
Grant number: RGPIN 239148-11, MOP-119455
Date Deposited: 29 Aug 2018 13:36
Last Modified: 24 Oct 2018 16:13
PolyPublie URL: https://publications.polymtl.ca/3236/
Document issued by the official publisher
Journal Title: European Spine Journal (vol. 25, no. 10)
Publisher: Springer
Official URL: https://doi.org/10.1007/s00586-016-4434-3

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