An Innovative Method to Develop Intelligent Spinal Orthosis for Scoliosis

青少年特发性脊柱侧凸（AIS）是一种病因不明的脊柱异常弯曲并伴有椎体旋转的疾病。 目前，支具治疗是脊柱侧凸最常用的非手术治疗方法，其目的是阻止进展。有一个相对较短的窗口支架治疗是有效的。研究报告，高初始内支具矫正和良好的顺应性是成功支具的重要因素。 在目前的实践中，支具的磨损紧密度水平和垫的位置是根据矫形师的经验设定的。太大的力会导致不适，并可能降低顺应性，但太小的力不会控制曲线。此外，衬垫放置不当将降低治疗效果，从而增加了拍摄更多支具内X线片和手术的可能性。因此，需要一种实时非侵入性方法来评估支具构建期间的脊柱矫正。 此外，简单地规定支具并不意味着支具佩戴者会正确佩戴。 因此，需要一种智能压力控制系统来监测脊柱矫形器内的多个压力点。该提案的目的是开发创新工具或先进方法，用于更好地了解AIS支具治疗有效性背后的科学基础，并改善脊柱侧凸支具治疗。三个次级目标是：1）开发可靠、有效的3D超声工具和技术，用于支具内或支具外脊柱侧凸的实时测量，2）确定最佳压力和位置，以实现最佳支具内矫正，3）开发人工智能矫形器-一种微计算机系统，可以动态控制多点压力，并可以根据特定治疗方案进行编程。

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.