Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (15): 3129-3137.doi: 10.12307/2025.198

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Biomechanical characteristics of different orthopedic modalities for adolescent idiopathic scoliosis based on finite element simulation analysis

Yue Bo1, 2, Cao Zhenhua3, 4, Zhang Yunfeng5, Xu Yangyang6, Jin Feng7, Su Baoke8, Wang Lidong9, Wang Xing1, Tong Ling1, Liu Qinghua1, Fang Yuan1, Sha Lirong1, Wang Haiyan1, Li Xiaohe1, Li Zhijun1#br#   

  1. 1Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University (Inner Mongolia Digital Transformation Medical Engineering Technology Research Center), Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Received:2023-02-28 Accepted:2024-06-07 Online:2025-05-28 Published:2024-11-04
  • Contact: Zhang Yunfeng, Associate chief physician, Department of Imaging, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Co-corresponding author: Li Xiaohe, Professor, Doctoral supervisor, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University (Inner Mongolia Digital Transformation Medical Engineering Technology Research Center), Hohhot 010000, Inner Mongolia Autonomous Region, China
  • About author:Yue Bo, Master candidate, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University (Inner Mongolia Digital Transformation Medical Engineering Technology Research Center), Hohhot 010000, Inner Mongolia Autonomous Region, China; Bayannur Hospital, Bayannur 015000, Inner Mongolia Autonomous Region, China Cao Zhenhua, MD, Associate chief physician, Postdoctoral Workstation of Chinese PLA General Hospital, Beijing 100000, China; Department of Orthopedics, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China Yue Bo and Cao Zhenhua contributed equally to this article.
  • Supported by:
    Inner Mongolia Autonomous Region Natural Science Foundation Project, No. 2021MS08086 (to WHY); 2022 Inner Mongolia Autonomous Region Health Science and Technology Plan Project, No. 202201188 (to WHY); Inner Mongolia Medical University 2020 “Achievement Transformation” Project, No. YKD2020CGZH009 (to WHY); Inner Mongolia Natural Science Foundation, No. 2020MS08124 (to LXH); Inner Mongolia Autonomous Region “Grassland Talent” Project Youth Innovation and Entrepreneurship Talent Project, No. 2020 (to LXH); Inner Mongolian Medical University Follow-Up Scientific Research Project, No. 2020 (to LXH); Inner Mongolia Science and Technology Plan Project, No. 2019GG115 (to LZJ); 2021 Inner Mongolia Autonomous Region Mongolian Medicine Collaborative Innovation Center Scientific Research Project (to LXH); 2021 Inner Mongolia Medical University Zhiyuan Talent Project (to LXH); Inner Mongolia Medical University 2021 School-Level Key Scientific Research Project, No. YKD2021ZD001 (to LXH); Inner Mongolia Education Department Higher Education Innovation Team Development Plan, No. NMGIRT2227 (to LXH) 

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Abstract: BACKGROUND: The asymmetrical biomechanical environment of adolescent idiopathic scoliosis can lead to further wedge deformation of the vertebral body, which may affect cardiopulmonary function and compress nerves in severe cases. Adolescent idiopathic scoliosis with different degrees of scoliosis should be treated with exercise, bracing, and surgery. However, the mechanical mechanism of selecting an orthopedic approach remains unclear due to the individual variability of patients. 
OBJECTIVE: To investigate the biomechanical mechanism of different orthopedic modalities for the treatment of adolescent idiopathic scoliosis to provide a basis for clinical selection of treatment modalities based on the spine model of adolescent idiopathic scoliosis patients. 
METHODS: Based on the CT images of an adolescent idiopathic scoliosis patient, a scoliosis model (C7-L5) was reconstructed in Mimics software in three dimensions, and lateral thrust force was applied at the T8/T9 thorax and vertical distraction force was applied over the C7 vertebra with the magnitude of 20, 40, 60, 80, 100, and 120 N. The intervertebral disc stress and vertebral displacement in concave and convex sides, and Cobb angle of the spine were analyzed under two orthopedic modalities.  
RESULTS AND CONCLUSION: (1) With lateral thrust, there was no significant change in the C7T1-T7T8 intervertebral disc. The concave and convex stress of T7T8-L4L5 segment decreased first and then increased with the increase of lateral thrust force. The correction effect of lateral thrust on the segment near T8T9 was obvious and weakened with the extension of the segment to the cephalic and caudal ends. At 120 N of lateral thrust, the thoracic Cobb angle changed from 53.2° to 32.5° and the lumbar Cobb angle changed from 50.2° to 43.9°. (2) With the vertical distraction, the thoracic intervertebral disc stresses first decreased and then increased, and all the lumbar disc stresses decreased. The C7 displacement was the most obvious, and the correction effect gradually diminished with the segment extended to the caudal end. At a vertical distraction force of 120 N, the thoracic Cobb angle changed from 53.2° to 39.4° and the lumbar Cobb angle changed from 50.2° to 47.6°. (3) It is concluded that both orthopedic modalities provide improvement in the degree of scoliosis, with the thoracic correction being greater than the lumbar correction. Also, the asymmetric stress distribution on the concave and convex sides is improved, which contributes to normal bone growth. A vertical distraction approach is appropriate for larger Cobb angles, and a lateral thrust approach is appropriate for smaller Cobb angles. The results of this study help to understand the mechanism of spinal orthosis and provide a theoretical basis for the choice of orthopedic approach.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: adolescent idiopathic scoliosis, lateral thrust force, vertical distraction force, asymmetric stress distribution, mechanical adjustment principle of bone, orthopedic biomechanics

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