An energy approach describes spine equilibrium in adolescent idiopathic scoliosis
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ORIGINAL PAPER
An energy approach describes spine equilibrium in adolescent idiopathic scoliosis Baptiste Brun‑Cottan1 · Pauline Assemat1 · Vincent Doyeux1 · Franck Accadbled1,2 · Jérôme Sales de Gauzy1,2 · Roxane Compagnon1,2 · Pascal Swider1 Received: 7 January 2020 / Accepted: 19 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The adolescent idiopathic scoliosis (AIS) is a 3D deformity of the spine whose origin is unknown and clinical evolution unpredictable. In this work, a mixed theoretical and numerical approach based on energetic considerations is proposed to study the global spine deformations. The introduced mechanical model aims at overcoming the limitations of computational cost and high variability in physical parameters. The model is constituted of rigid vertebral bodies associated with 3D effective stiffness tensors. The spine equilibrium is found using minimization methods of the mechanical total energy which circumvents forces and loading calculation. The values of the model parameters exhibited in the stiffness tensor are retrieved using a combination of clinical images post-processing and inverse algorithms implementation. Energy distribution patterns can then be evaluated at the global spine scale to investigate given time patient-specific features. To verify the reliability of the numerical methods, a simplified model of spine was implemented. The methodology was then applied to a clinical case of AIS (13-year-old girl, Lenke 1A). Comparisons of the numerical spine geometry with clinical data equilibria showed numerical calculations were performed with great accuracy. The patient follow-up allowed us to highlight the energetic role of the apical and junctional zones of the deformed spine, the repercussion of sagittal bending in sacro-illiac junctions and the significant role of torsion with scoliosis aggravation. Tangible comparisons of output measures with clinical pathology knowledge provided a reliable basis for further use of those numerical developments in AIS classification, scoliosis evolution prediction and potentially surgical planning. Keywords Global spine · Scoliosis · Mechanical model · Functional minimization · Inverse problem · Medical imaging
1 Introduction The adolescent idiopathic scoliosis (AIS) is a multifactorial disease potentially involving genetic, metabolic and mechanical aspects, and which affects up to 3% of the 10–16 years population with a significant female prevalence. AIS is characterized by the deviation of anatomical spine curvature toward coupled 3D deformation involving abnormal bending and torsion. It generally shows a rapid evolution during the growth spurt (Riseborough and Wynne-Davies 1973) which can lead to respiratory and cardiac disorders. * Pascal Swider [email protected] 1
Institut de Mécanique des Fluides de Toulouse, IMFT, CNRS, Université de Toulouse, Toulouse, France
Children Hospital, Toulouse University Hospital, Toulouse, France
2
If orthotic treatment fails to stop progression which happe
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