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Open Access Highly Accessed Research

Preoperative assessment and evaluation of instrumentation strategies for the treatment of adolescent idiopathic scoliosis: computer simulation and optimization

Younes Majdouline12, Carl-Eric Aubin12*, Xiaoyu Wang1, Archana Sangole12 and Hubert Labelle2

Author Affiliations

1 Department of Mechanical Engineering, École Polytechnique, Universite de Montreal, P.O. Box 6079, Downtown Station, Montréal, Québec H3C 3A7, Canada

2 Research Center, Sainte-Justine University Hospital Center of Universite de Montreal, 3175, Cote Sainte-Catherine Rd, Montréal, Québec H3T 1C5, Canada

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Scoliosis 2012, 7:21  doi:10.1186/1748-7161-7-21

Published: 26 November 2012

Abstract

Background

A large variability in adolescent idiopathic scoliosis (AIS) correction objectives and instrumentation strategies was documented. The hypothesis was that different correction objectives will lead to different instrumentation strategies. The objective of this study was to develop a numerical model to optimize the instrumentation configurations under given correction objectives.

Methods

Eleven surgeons from the Spinal Deformity Study Group independently provided their respective correction objectives for the same patient. For each surgeon, 702 surgical configurations were simulated to search for the most favourable one for his particular objectives. The influence of correction objectives on the resulting surgical strategies was then evaluated.

Results

Fusion levels (mean 11.2, SD 2.1), rod shapes, and implant patterns were significantly influenced by correction objectives (p < 0.05). Different surgeon-specified correction objectives produced different instrumentation strategies for the same patient.

Conclusions

Instrumentation configurations can be optimized with respect to a given set of correction objectives.

Keywords:
Scoliosis; Instrumentation; Simulation; Modeling; Optimization; 3-D correction