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16.03.2019 | Original Article | Ausgabe 6/2019

European Spine Journal 6/2019

Prediction of brace effect in scoliotic patients: blinded evaluation of a novel brace simulator—an observational cross-sectional study

European Spine Journal > Ausgabe 6/2019
Aurélien Courvoisier, Matthieu Nesme, Julien Gerbelot, Alexandre Moreau-Gaudry, François Faure
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-019-05948-9) contains supplementary material, which is available to authorized users.

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Bracing is the most commonly used treatment for scoliosis. But braces remain predominantly “handcrafted.” Our objective was to create a novel brace simulator using a high-fidelity 3D “avatar” of the patient’s trunk.


An observational cross-sectional study was constructed. The inclusion criteria were patients with a moderate idiopathic scoliosis (between 15° and 35° of Cobb angle) aged between 9 and 15 years old with an indication of brace treatment. Twenty-nine scoliotic patients, 25 girls and four boys, with a mean age of 12.4 years were included. Twenty right thoracic and 14 left lumbar were measured with a mean Cobb angle of 24°. 3D “avatars” were generated using a novel technology called the “anatomy transfer.” Biomedical simulations were conducted by engineers who were blinded to the clinical effect of the real patient brace. The in-brace Cobb angle effect (real effect) was compared with the virtual numeric in-brace Cobb angle observed using the blindly constructed avatar (simulation effect).


Real and simulated in-brace Cobb angle were compared using a paired two-sided Student’s t test. The real mean Cobb angle was 11° and 17° in the simulation which was statistically significant. The strength of prediction of the simulation was assessed for each individual patient; 76% of the real in-brace Cobb angles had good and moderate prediction (± 10°).


Incorporating high-fidelity copy of the entire 3D shape of the patient’s trunk and multiple 3D-reconstructed bony images into an anatomical reference avatar resulted in moderate-to-good prediction of brace effect in three quarters of patients.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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