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Ortez Dizaynında Biyomekanik Simulasyon ve Standart Tekniğin Adolesan İdiyopatik Skolyoz Tedavisindeki Etkilerinin Karşılaştırılması: İlk Sonuçlar

Assessment of Aortic Elasticity and Its Relation with Left Ventricular Filling and Diastolic Parameters by Transthoracic and Transesophageal Echocardiography

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DOI: 
doi: 10.5505/abantmedj.2013.55707

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Abstract (2. Language): 
Objective: Scoliosis is a 3-dimensional deformity. Today, the use of orthesis for medium and light degree of deformities is one of the most widely applied treatment models. There are many question marks regarding the application of the best orthesis. The use and effectiveness of orthesis has still been discussed. Today, with industrial new generation orthesis in addition to the developments in CAD/CAM and computer-ized biomechanical simulation technologies, the treatment of deformity has become possible by providing optimal biomechanical efficiency. The aim of this study is to compare effectiveness of two different orthesis design technique in conservative treatment of adolescent idiopathic scoliosis. Method: The study included 28 patients with scoliosis (22 females and 6 males, mean age 15.8) whose follow-up was retrospectively complete for the study. Patients were divid-ed into 2 groups. The first group: It was consisted of 16 patients who were treated with TLSO type prepared by using the standard design methods. Second group: It was consist-ed of 12 patients for whom orthesis which were carried out with 3-dimensional finite element model as biomechanics of the individual geometry in design and production process and CAD/CAM software (Rodin4®) were used. At the begin-ning and sixth month follow-up of patients, their Cobb's angles were measured by taking a standing x-ray of them with long cassette. Results: At the end of six months,while improvements at Cobb's angle in thoracic-lumbar deviousness in the first group were 18%-22%,in the second group,they were obser-ved as 29%-42% (p <0.05). The second group of cobb’s ang-les and patient comfort showed significantly better results. Conclusion: These first results suggests that new generation orthesis can be more effective on the conservative treat-ment of scoliosis. We believe that this method will give us direction to understand and improve the orthesis biomec-hanics.
Abstract (Original Language): 
Amaç: Skolyoz 3 boyutlu bir deformitesidir. Orta ve hafif dereceli deformitelerde ortez kullanımı günümüzde en yay-gın uygulanan tedavi modellerinden biridir. Ortezin kullanım ve etkinliği hala tartışılmaktadır. Günümüzde CAD /CAM ve bilgisayarlı biyomekanik simulasyon teknolojilerindeki geliş-melerle birlikte endüstriyel yeni jenerasyon ortezlerle de-formitenin optimal biyomekanik etkinlik sağlanarak tedavisi-ne olanak sağlanmıştır. Bu çalışmanın amacı adolesan idiyo-patik skolyozon konservatif tedavisinde 2 farklı ortez dizayn tekniğinin etkinliklerinin karşılaştırılmasıdır. Yöntem: Çalışmaya retrospektif olarak takipleri eksiksiz olan 28 (22 kadın, 6 erkek, ortalama yaş 15.8) skolyozlu hasta dahil edildi. Hastalar 2 gruba ayrıldı. Birinci grup: Standart dizayn yöntemleri kullanılarak hazırlanan TLSO tipi kullana-rak tedavi edilen 16 hastadan oluştu. İkinci grup: diazyn ve üretim aşamasının bireysel geometrinin biyomekanik olarak 3 boyutlu sonlu elemanlar modeli ve CAD/CAM yazılımları (Rodin4®) ile gerçekleştirildiği ortezleri kullanılan 12 hasta-dan oluştu. Hastaların başlangıç ve 6. ay takiplerinde uzun kaset ayakta röntgenleri çekilerek cobb’s açıları ölçüldü. Bulgular: Altı ay sonunda Birinci grupta torakal-lomber eğriliklerdeki cobb’s açısındaki düzelmeler 18%-22% iken, İkinci grupta 29%-42% (p <0,05) olarak izlendi. İkinci grupta cobb's açılarında ve hasta komforunda belirgin olarak daha iyi sonuçlar izlendi. Sonuç: Bu ilk sonuçlar yeni jenerasyon ortezlerin skolyozun konservatif tedavsinde daha etkili olabileceğini düşündür-mektedir. Bu yöntemin ortez biyomekaniğini anlamamıza ve geliştirmemize yön vereceğine inanmaktayız.
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