Scoliocorrector Fatma-UI for correction of adolescent idiopathic scoliosis: Development, effectivity, safety and functional outcome

P. Phedy, I. H. Dilogo, Wresti Indriatmi, Sugeng Supriadi, Marcel Prasetyo, Fitri Octaviana, Zairin Noor
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Abstract

BACKGROUND Adolescent idiopathic scoliosis remains a major problem due to its high incidence, high risk, and high cost. One of the aims of the management in scoliosis is to correct the deformity. Many techniques are available to correct scoliosis deformity; however, they are all far from ideal to achieve three-dimensional correction in scoliosis. AIM To develop a set of tools named Scoliocorrector Fatma-UI (SCFUI) to aid three-dimensional correction and to evaluate the efficacy, safety, and functional outcome. METHODS This study consists of two stages. In the first stage, we developed the SCFUI and tested it in finite element and biomechanical tests. The second stage was a single-blinded randomized clinical trial to evaluate the SCFUI compared to direct vertebral rotation (DVR). Forty-four subjects with adolescent idiopathic scoliosis were randomly allocated into the DVR group (n = 23) and SCFUI group (n = 21). Radiological, neurological, and functional outcome was compared between the groups. RESULTS Finite element revealed the maximum stress of the SCFUI components to be between 31.2 - 252 MPa. Biomechanical analysis revealed the modulus elasticity of SCFUI was 9561324 ± 633277 MPa. Both groups showed improvement in Cobb angle and sagittal profile, however the rotation angle was lower in the SCFUI group (11.59 ± 7.46 vs 18.23 ± 6.39, P = 0.001). Neurological and functional outcome were comparable in both groups. CONCLUSION We concluded that SCFUI developed in this study resulted in similar coronal and sagittal but better rotational correction compared to DVR. The safety and functional outcomes were also similar to DVR.
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用于矫正青少年特发性脊柱侧凸的脊柱侧凸矫正器 Fatma-UI:开发、有效性、安全性和功能结果
背景 青少年特发性脊柱侧弯症发病率高、风险大、费用高,因此一直是个大问题。治疗脊柱侧弯的目的之一是矫正畸形。目前有许多矫正脊柱侧弯畸形的技术,但要实现脊柱侧弯的三维矫正,这些技术还远远不够理想。目的 开发一套名为 "脊柱侧弯矫正器 Fatma-UI(SCFUI)"的工具,用于辅助三维矫正,并评估其有效性、安全性和功能结果。方法 本研究包括两个阶段。第一阶段,我们开发了 SCFUI,并对其进行了有限元和生物力学测试。第二阶段是单盲随机临床试验,评估 SCFUI 与直接椎体旋转(DVR)的比较。44 名患有青少年特发性脊柱侧凸的受试者被随机分配到 DVR 组(23 人)和 SCFUI 组(21 人)。比较两组的放射学、神经学和功能结果。结果 有限元显示 SCFUI 组件的最大应力在 31.2 - 252 兆帕之间。生物力学分析显示,SCFUI 的弹性模量为 9561324 ± 633277 兆帕。两组患者的 Cobb 角和矢状面均有所改善,但 SCFUI 组的旋转角度较低(11.59 ± 7.46 vs 18.23 ± 6.39,P = 0.001)。两组患者的神经和功能预后相当。结论 我们得出结论,与 DVR 相比,本研究中开发的 SCFUI 具有相似的冠状面和矢状面矫正效果,但旋转矫正效果更好。安全性和功能性结果也与 DVR 相似。
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