Immediate Correction of Idiopathic Scoliosis With Nighttime Braces Created by a Fully Automated Generative Design Algorithm: A Randomized Controlled Crossover Trial.

Study Design: Single-center, double-blinded, prospective crossover randomized controlled trial.

Objective: To clinically validate the efficacy of nighttime braces designed automatically by a generative design algorithm to treat idiopathic scoliosis (IS). The tested hypothesis was the clinical equivalence of immediate in-brace correction for the new automatically generated brace design versus a standard Providence-type brace.

Planar cell polarity zebrafish models of congenital scoliosis reveal underlying defects in notochord morphogenesis.

Congenital scoliosis (CS) is a type of vertebral malformation for which the etiology remains elusive. The notochord is pivotal for vertebrae development, but its role in CS is still understudied. Here, we generated a zebrafish knockout of ptk7a, a planar cell polarity (PCP) gene that is essential for convergence and extension (C&E) of the notochord, and detected congenital scoliosis-like vertebral malformations (CVMs).

Finite element analysis of distraction osteogenesis with a new extramedullary internal distractor.

Distraction osteogenesis (DO) is a bone regenerative maneuver, which is conventionally done with external fixators and, more recently, with telescopic intramedullary nails. Despite the proven effectiveness, external approaches are intrusive to the patient's life while intramedullary nailing damages the growth plates, making them unsuitable for pediatric patients. An internal DO plate fixator (IDOPF) was developed for pediatric patients to address these limitations.

Automated design of nighttime braces for adolescent idiopathic scoliosis with global shape optimization using a patient-specific finite element model.

Adolescent idiopathic scoliosis is a complex three-dimensional deformity of the spine, the moderate forms of which require treatment with an orthopedic brace. Existing brace design approaches rely mainly on empirical manual processes, vary considerably depending on the training and expertise of the orthotist, and do not always guarantee biomechanical effectiveness. To address these issues, we propose a new automated design method for creating bespoke nighttime braces requiring virtually no user input in the process.

Optimized braces for the treatment of adolescent idiopathic scoliosis: A study protocol of a prospective randomised controlled trial.

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.

Effectiveness of SplashGuard Caregiver prototype in reducing the risk of aerosol transmission in intensive care unit rooms of SARS-CoV-2 patients: a prospective and simulation study.

Background: The contagiousness of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is known to be linked to the emission of bioaerosols. Thus, aerosol-generating procedures (AGPs) could increase the risk of infection among healthcare workers (HCWs).

Aim: To investigate the impact of an aerosol protection box, the SplashGuard Caregiver (SGGC) with suction system, by direct analysis of the presence of viral particles after an AGP, and by using the computational fluid dynamics (CFD) simulation method.

A novel method for assigning bone material properties to a comprehensive patient-specific pelvic finite element model using biplanar multi-energy radiographs.

The increasing prevalence of adult spinal deformity requires long spino-pelvic instrumentation, but pelvic fixation faces challenges due to distal forces and reduced bone quality. Bi-planar multi-energy X-rays (BMEX) were used to develop a patient-specific finite element model (FEM) for evaluating pelvic fixation. Calibration involved 10 patients, and an 81-year-old female test case was used for FEM customization and pullout simulation validation.

The Effect of Implant Density on Adolescent Idiopathic Scoliosis Fusion: Results of the Minimize Implants Maximize Outcomes Randomized Clinical Trial.

Background: Severe adolescent idiopathic scoliosis (AIS) can be treated with instrumented fusion, but the number of anchors needed for optimal correction is controversial.

Methods: We conducted a multicenter, randomized study that included patients undergoing spinal fusion for single thoracic curves between 45° and 65°, the most common form of operatively treated AIS. Of the 211 patients randomized, 108 were assigned to a high-density screw pattern and 103, to a low-density screw pattern.

Powerful, soft combustion actuators for insect-scale robots.

Insects perform feats of strength and endurance that belie their small stature. Insect-scale robots-although subject to the same scaling laws-demonstrate reduced performance because existing microactuator technologies are driven by low-energy density power sources and produce small forces and/or displacements. The use of high-energy density chemical fuels to power small, soft actuators represents a possible solution.

High Fat High Sugar Diet Reduces Small Intestinal Secretion by Sex-Dependent Mechanisms.

Background/aims: The goal of this study was to determine the influence of high-fat high-sugar diet (Western diet) on intestinal function and subsequently to determine if there were any beneficial effects of exercise, genistein (a naturally occurring phytoestrogen) or both, on the intestine.

Methods: We measured transepithelial short circuit current (I), across freshly isolated segments of jejunum from male and female C57Bl/6J mice randomly assigned to one of the following groups for the 12-week study duration: high-fat high-sugar diet (HFS), HFS with genistein (Gen), HFS with exercise (Ex), or HFS with both genistein and exercise (Gen+Ex) and compared them to lean controls. Genistein concentration was 600 mg genistein/kg diet.

A Novel Methodology to Estimate Bone Mechanical Properties Using Dual-Energy Imaging to Improve Pedicle Screw Fixation.

Objective: To develop a methodology to improve the representation of the mechanical properties of a vertebral finite element model (FEM) based on a new dual-energy (DE) imaging technology to improve pedicle screw fixation.

Methods: Bone-calibrated radiographs were generated with dual-energy imaging technology in order to estimate the mechanical properties of the trabecular bone. Properties were included in regions of interest in four vertebral FEMs representing heterogeneity and homogeneity, as a realistic and reference model, respectively.

The use of deep learning in medical imaging to improve spine care: A scoping review of current literature and clinical applications.

Background: Artificial intelligence is a revolutionary technology that promises to assist clinicians in improving patient care. In radiology, deep learning (DL) is widely used in clinical decision aids due to its ability to analyze complex patterns and images. It allows for rapid, enhanced data, and imaging analysis, from diagnosis to outcome prediction.

Concave rod first vs. convex rod first in AIS instrumentation with differential rod contouring: computer modeling and simulations based on ten AIS surgical cases.

Purpose: To assess biomechanical differences between AIS instrumentations using concave vs. convex rod first.

Methods: Instrumentations of ten AIS patients were simulated first with major correction maneuvers using the concave rod then with convex rod.

Biomechanical Computational Study of Pedicle Screw Position and Density in Adolescent Idiopathic Scoliosis Instrumentation.

Study Design: Computer simulation of adolescent idiopathic scoliosis instrumentation.

Objective: To test the hypothesis that different screw densities would result in different apical vertebral rotation (AVR) corrections and bone-screw forces in adolescent idiopathic scoliosis instrumentation.

Summary Of Background Data: The "Minimize Implants Maximize Outcomes" Clinical Trial revealed that the use of more versus fewer screws resulted in similar coronal plane correction for Lenke 1A curves.

Biomechanical analysis of rod contouring in posterior spinal instrumentation and fusion for 3D correction of adolescent idiopathic scoliosis.

Purpose: To biomechanically evaluate 3D corrective forces and deformity correction attributable to key parameters of rod contouring in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).

Methods: Computerised patient-specific biomechanical models of six AIS cases were used to simulate PSF and evaluate the effects of 5.5-mm cobalt-chrome rod contouring angle (concave-convex angles: 30°-15°, 45°-15° and 60°-15°), length (spanning 4 and 7 vertebrae), and apex location (T7, T9).

Biomechanical modeling and assessment of lumbar vertebral body tethering configurations.

Purpose: Vertebral body tethering (VBT) is a fusionless spinal growth modulation technique, which shows promise for pediatric idiopathic scoliosis (IS) curve correction. This technique, mainly used for thoracic curves, is increasingly being used to treat lumbar curves in order to preserve spine flexibility. It remains necessary to adequately define the cord tension to be applied during the operation and the instrumented levels to biomechanically predict correction over time for the lumbar spine.

Finite element simulation of growth modulation during brace treatment of adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) is a spine deformity whose progression during growth is affected by asymmetrical loads acting on the spine. The conservative brace treatment aims to limit the deformity's progression until the end of skeletal growth. This study's objective was to develop a patient-specific finite element model (FEM) simulating immediate in-brace (IB) correction and subsequent growth modulation over 2 years of treatment.

Subchondroplasty in the treatment of bone Marrow lesion in early Knee Osteoarthritis: A systematic review of clinical and radiological outcomes.

Background: Knee osteoarthritis (KOA) is increasingly prevalent in North American society. The significant societal burden it represents makes it essential to promote and target new treatments in earlier phases of the disease. Among others, subchondroplasty is a newly documented technique using calcium phosphate injection targeting the osteochondral lesions preceding KOA, also known as Bone Marrow Lesions (BMLs).

Prevention of submicron aerosolized particle dispersion: evaluation of an aerosol box using a pediatric simulation model.

The SplashGuard CG (SG) is a barrier enclosure developed to protect healthcare workers from SARS-CoV-2 transmission during aerosol-generating procedures. Our objective was to evaluate the protection provided by the SG against aerosolized particles (AP), using a pediatric simulation model of spontaneous ventilation (SV) and noninvasive ventilation (NIV). An aerosol generator was connected to the airways of a pediatric high-fidelity manikin with a breathing simulator.

Influence of spinal lordosis correction location on proximal junctional failure: a biomechanical study.

Study Design: Assessment of sagittal lordosis distribution on mechanical proximal junctional failure-related risks through computer-based biomechanical models.

Objective: To biomechanically assess how lordosis distribution influences radiographical and biomechanical indices related to Proximal Junctional Failure (PJF). The "optimal" patient-specific targets to restore the sagittal balance in posterior spinal fusion are still not known.

Proximal junctional failure after surgical instrumentation in adult spinal deformity: biomechanical assessment of proximal instrumentation stiffness.

Study Design: Assessment of different proximal instrumentation stiffness features to minimize the mechanical proximal junctional failure-related risks through computer-based biomechanical models.

Objective: To biomechanically assess variations of proximal instrumentation and loads acting on the spine and construct to minimize proximal junctional failure (PJF) risks. The use of less-stiff fixation such as hooks or tensioned bands, compared to pedicle screws, at the proximal instrumentation level are considered to allow for a gradual transition in stiffness with the adjacent levels, but the impact of such flexible fixation on the loads balance and complications such as PJF remain uncertain.

Prediction of post-operative adding-on or compensatory lumbar curve correction after anterior vertebral body tethering.

Purpose: Anterior Vertebral Body Tethering (AVBT), a fusionless surgical technique based on growth modulation, aims to correct pediatric scoliosis over time. However, medium-term curvature changes of the non-instrumented distal lumbar curve remains difficult to predict. The objective was to biomechanically analyze the level below the LIV to evaluate whether adding-on or compensatory lumbar curve after AVBT can be predicted by intervertebral disc (ID) wedging and force asymmetry.