1. Optimized braces for the treatment of adolescent idiopathic scoliosis: A study protocol of a prospective randomised controlled trial.
- Author
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Coulombe M, Guy A, Barchi S, Labelle H, and Aubin CĂ
- Subjects
- Humans, Adolescent, Child, Spine, Radiography, Conservative Treatment methods, Treatment Outcome, Randomized Controlled Trials as Topic, Scoliosis diagnostic imaging, Scoliosis therapy, Kyphosis
- Abstract
Introduction: Adolescent Idiopathic Scoliosis (AIS) is a 3D deformity of the spine that affects 3% of the adolescent population. Conservative treatments like bracing aim to halt the progression of the curve to the surgical threshold. Computer-aided design and manufacturing (CAD/CAM) methods for brace design and manufacturing are becoming increasingly used. Linked to CAD/CAM and 3D radiographic reconstruction techniques, we developed a finite element model (FEM) enabling to simulate the brace effectiveness before its fabrication, as well as a semi-automatic design processes. The objective of this randomized controlled trial is to compare and validate such FEM semi-automatic algorithm used to design nighttime Providence-type braces., Methods and Analysis: Fifty-eight patients with AIS aged between 10 to 16-years and skeletally immature will be recruited. At the delivery stage, all patients will receive both a Providence-type brace optimized by the semi-automatic algorithm leveraging a patient-specific FEM (Test) and a conventional Providence-type brace (Control), both designed using CAD/CAM methods. Biplanar radiographs will be taken for each patient with both braces in a randomized crossover approach to evaluate immediate correction. Patients will then be randomized to keep either the Test or Control brace as prescribed with a renewal if necessary, and will be followed over two years. The primary outcome will be the change in Cobb angle of the main curve after two years. Secondary outcomes will be brace failure rate, quality of life (QoL) and immediate in-brace correction. This is a single-centre study, double-blinded (participant and outcome assessor) randomized controlled trial (RCT)., Trial Registration Number: ClinicalTrials.gov: NCT05001568., Competing Interests: MC and AG are cofounders and shareholders of Modulate Technologies Inc. HL is a cofounder and shareholder of Spinologics Inc. CEA has a discovery grant from the Natural Sciences and Engineering Research Council of Canada (NSERC), and a NSERC industrial research grant with Medtronic of Canada paid to the university (outside the scope of the current study). SB declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The NSERC grant with Medtronic was not been used to fund this research project. A patent application on the optimization algorithm has been submitted. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Coulombe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
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