Development of CAD/CAM Based Brace Models for the Treatment of Patients with Scoliosis-Classification Based Approach versus Finite Element Modelling

STUDY DESIGN Retrospective controlled cohort study comparing the in-brace correction of two samples of scoliosis patients with braces of different computer aided design (CAD). PURPOSE In-brace correction and compliance correlate with outcome. The more standardized CAD braces that are available should enable improved in-brace correction and outcome. This study compared recent CAD brace developments with respect to in-brace corrections. OVERVIEW OF LITERATURE A 2013 randomized controlled trial demonstrated that 72% of a population complying to Scoliosis Research Society inclusion criteria on bracing did not progress using braces (mainly Boston braces) used in the United States and Canada with moderate corrective effect. METHODS In-brace corrections achieved in a sample of patients fulfilling the inclusion criteria for studies on bracing using the classification based approach (CBA) were compared to the recent individual CAD/computer aided manufacturing bracing based on finite element modelling approach (FEMA). RESULTS In-brace corrections using the different approaches differed widely. CBA in-brace corrections were 66% of the initial value. FEMA in-brace correction was 42% of the initial value. CONCLUSIONS Considering the fact that in-brace correction (and compliance) determines the end result of bracing in the treatment of scoliosis, scoliosis braces based on CBA are superior to the FEMA and the standard plaster based brace applications.