An Innovative Method to Develop Intelligent Spinal Orthosis for Scoliosis

青少年特发性脊柱侧凸(AIS)是一种伴有脊柱旋转的脊柱异常曲度，其原因不明。目前，支具治疗是脊柱侧弯最常用的非手术治疗方法，其目的是阻止脊柱侧弯的进展。支架治疗有一个相对较短的有效窗口。研究表明，高初始支具矫正率和良好的顺应性是支具成功的重要因素。在目前的实践中，支具磨损紧密程度和垫片的位置都是根据正畸医生的经验来设置的。用力太大会引起不适，并可能降低顺应性，但用力太少并不能控制曲线。此外，不良的垫片放置将降低治疗的有效性，从而增加接受更多支具X线片和手术的可能性。因此，需要一种实时非侵入性的方法来评估支具建造过程中的脊柱矫正度。此外，简单地规定戴牙套并不意味着佩戴者会正确地戴上它。因此，需要一种智能压力控制系统来监控脊柱矫形器内部的多个压力点。这项建议的目的是开发创新的工具或先进的方法，以更好地了解AIS支具治疗效果背后的科学基础，并改进脊柱侧弯的支具治疗。三个子目标是：1)开发可靠、有效的三维超声工具和技术，用于实时测量脊柱侧弯的支具内或支具外；2)确定将导致最佳支具矫正的最佳压力和位置；以及3)开发一种人工智能矫形器--一种可以动态控制多点压力并可通过特定治疗方案编程的微型计算机系统。

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.