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The outcomes of brace treatment for scoliosis depend on how the brace is used. Simply prescribing a brace does not mean it will be worn properly. A smart brace has been developed to control the brace wear tightness with the expectation that appropriately worn braces will improve outcomes. Twelve brace candidates (10F; 2M) agreed to participate into this study and were randomly divided into 2 groups. The smart brace group used the smart brace for the first year, and then wore the standard brace for the following year. The standard rigid brace group wore their TLSO for 2 years. Both groups were followed for 3 years after they finished the brace treatment. The smart brace group showed better quality of brace wear, wearing their brace at the prescribed tightness level a higher proportion of time than the standard brace group. All subjects in the smart brace group had successful outcomes, Cobb angle changed less than 5°, whereas 2/6 subjects in the standard brace group had unsuccessful bracing. One had 7° increment and 1 underwent surgery. The smart brace group also reported that the smart brace was more comfortable to wear than the standard rigid brace. [ABSTRACT FROM AUTHOR]

Bracing is the most commonly used non-surgical treatment for adolescent idiopathic scoliosis (AIS) and requires an extensive commitment on the part of the patient and family. However, demonstrating efficacy of brace treatment for AIS has been hampered by the lack of compressive information about wear characteristics. The first 6 months is considered a critical time to evaluate whether AIS patients will commit to the treatment and may predict the treatment outcome. The characteristics of brace wear can assist clinicians to provide better support and aid long term compliance with treatment. This study describes the first 6 month brace wear characteristics in 15 AIS patients (12F;3M) who were prescribed full-time brace wear. There was a statistically significant increase in wear time (p = 0.02) after brace fitting and the brace wear tightness stabilized after month 4. The force at the major pressure pad area continuously decreased after month 2. A moderate correlation was found between the (quantity * quality) of the brace wear at month 6 and the change of Cobb angle (first out of brace - pre brace) (r2 = 0.47). The more time that the brace was worn and the higher proportion of time worn at the prescribed tightness or above improves the likelihood of a better treatment result. [ABSTRACT FROM AUTHOR]

Scoliosis surgery involves the insertion of screws and/or hooks into selected vertebrae to secure a pre-bent rod placed along the concave side of the spine. Usually conventional x-rays will be taken before the surgery to plan the alignment and positioning of the pedicle screws. However, reports state that perforation rate range from 6% to 54%. A misalignment of a pedicle screw can potentially cause permanent neurological spinal cord injury or even a lifethreatening vascular injury. Because of the importance of positioning and aligning of pedicle screws, we are working on an ultrasound method to guide the insertion of pedicle screws in real time. A pulse-echo immersion experiment was set up to study how well the edges of cortical bone could be detected using a bovine spinous process in-vitro. Two ultrasound frequencies (3.5 MHz and 5.0 MHz) were considered in this study. This preliminary study shows that ultrasound is able to penetrate cortical bone and reflect back from the outer boundary. All interfaces are clearly identified for both frequencies. Strong reflection signals are obtained when the beam is normal to the interface. Derived thickness values from the reflections are comparable with those from micro-CT image. The 5.0MHz ultrasound frequency provided better resolution than the 3.0 MHz frequency. [ABSTRACT FROM AUTHOR]