European Spine Journal

, Volume 28, Issue 6, pp 1277–1285 | Cite as

Prediction of brace effect in scoliotic patients: blinded evaluation of a novel brace simulator—an observational cross-sectional study

  • Aurélien CourvoisierEmail author
  • Matthieu Nesme
  • Julien Gerbelot
  • Alexandre Moreau-Gaudry
  • François Faure
Original Article



Bracing is the most commonly used treatment for scoliosis. But braces remain predominantly “handcrafted.” Our objective was to create a novel brace simulator using a high-fidelity 3D “avatar” of the patient’s trunk.


An observational cross-sectional study was constructed. The inclusion criteria were patients with a moderate idiopathic scoliosis (between 15° and 35° of Cobb angle) aged between 9 and 15 years old with an indication of brace treatment. Twenty-nine scoliotic patients, 25 girls and four boys, with a mean age of 12.4 years were included. Twenty right thoracic and 14 left lumbar were measured with a mean Cobb angle of 24°. 3D “avatars” were generated using a novel technology called the “anatomy transfer.” Biomedical simulations were conducted by engineers who were blinded to the clinical effect of the real patient brace. The in-brace Cobb angle effect (real effect) was compared with the virtual numeric in-brace Cobb angle observed using the blindly constructed avatar (simulation effect).


Real and simulated in-brace Cobb angle were compared using a paired two-sided Student’s t test. The real mean Cobb angle was 11° and 17° in the simulation which was statistically significant. The strength of prediction of the simulation was assessed for each individual patient; 76% of the real in-brace Cobb angles had good and moderate prediction (± 10°).


Incorporating high-fidelity copy of the entire 3D shape of the patient’s trunk and multiple 3D-reconstructed bony images into an anatomical reference avatar resulted in moderate-to-good prediction of brace effect in three quarters of patients.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Brace Scoliosis Brace simulator Avatar Patient specific 



We acknowledge Dr Kelly Dilworth for the manuscript English review.


Grenoble Alps University Hospital Innovation Grant 2015.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_5948_MOESM1_ESM.pptx (1.5 mb)
Supplementary material 1 (PPTX 1527 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Aurélien Courvoisier
    • 1
    Email author
  • Matthieu Nesme
    • 2
  • Julien Gerbelot
    • 3
  • Alexandre Moreau-Gaudry
    • 4
  • François Faure
    • 2
  1. 1.Grenoble Alps Scoliosis and Spine Center-Grenoble Alps University Hospital. SPM-TIMC-IMAGGrenoble Cedex 09France
  2. 2.Anatoscope-Cap-Omega Rond-Point Benjamin FranklinMontpellierFrance
  3. 3.Demeure OrthopédieSaint-Martin-d’HèresFrance
  4. 4.CIC-ITTIMC-IMAGLa TroncheFrance

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