Looking beyond the radiograph in AIS: Subject-specific modelling to investigate and predict the post-op spinal mobility

Adolescent Idiopathic Scoliosis (AIS) is a growth defect of the spine that primarily occurs in pre-pubertal children and is defined as a 3D deformity of the spine. When a curve reaches 50 degrees and is clinically expected to progress, surgery is recommended. Even though AIS is a 3D spinal deformity the surgical decision making is still based on 2D static radiographic parameters. The lack of 3D and dynamic criteria driving the selection of the vertebras to be instrumented might explain the relative high prevalence of undesired surgical outcome in AIS. Therefore, the overall aim of this project is to look beyond the radiographs and initiate the shift to 3D dynamically informed decision-making in AIS. A 3D dynamic subject-specific musculoskeletal AIS model will be developed together with an integrated simulation framework that can predict the radiographic and functional outcome of the surgery. The dynamic data (e.g. in terms of spinal mobility) obtained by these novel approaches will be compared for different surgical techniques (such as, Vertebral body Tethering and Spinal Fusion surgery) in order to optimize the treatment selection in AIS.