An Innovative Method to Develop Intelligent Spinal Orthosis for Scoliosis

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Adolescent idiopathic scoliosis (AIS) is abnormal curvature of the spine with vertebral rotation and its cause is unknown. Currently, brace treatment is the most commonly used non-surgical treatment for scoliosis and its goal is to stop progression. There is a relatively short window for brace treatment to be effective. Studies report that high initial in-brace correction and good compliance are important factors in successful bracing. In current practice, brace wear tightness level and locations of pads are set according to orthotist experience. Too much force causes discomfort and likely reduces compliance, but too little force does not control the curve. Furthermore, poor pad placement will reduce the effectiveness of treatment thus increasing the likelihood of taking more in-brace radiographs and surgery. Therefore, a real-time non-invasive method to assess spinal correction during brace construction is required. Furthermore, simply prescribed a brace does not mean the brace wearer will wear it properly. Thus, an intelligent pressure control system to monitor multiple pressure points inside a spinal orthosis is needed. The objective of this proposal is to develop innovative tools or advanced methods that can be used to better understand the scientific basis behind brace treatment effectiveness for AIS and to improve the brace treatment for scoliosis. Three sub-goals are: 1) to develop reliable, valid 3D ultrasound tool and techniques for real-time measurement of scoliosis in-brace or out of brace, 2) to determine the optimum pressures and locations that will lead to the best in-brace corrections, and 3) to develop an artificial intelligent orthosis - a microcomputer system that can dynamically control pressure at multiple points and can be programmed with a specific treatment protocol.