Immediate Non-Surgical Spinal Curvature Correction in Patients with Adolescent Idiopathic Scoliosis: A Pilot Study of Digitalised 3D Scoliosis Correction with Ultrasound Imaging Evaluation

Background: Adolescent idiopathic scoliosis (AIS), which affects 1-3% of adolescents, is a progressive three-dimensional spinal deformity requiring early intervention to prevent functional impairments and curvature progression. Current non-surgical treatments face challenges in delivering consistent and bidirectional corrective forces due to limitations in force control and integration. Some recent studies indicate that a novel digitalized three-dimensional (3D) spinal decompression and correction system may enhance the spinal flexibility, body height and brace-wearing comfort. However, its effect on the curvature changes has remained unclear. Methods: This study employed the radiation-free ultrasound imaging to quantify the immediate curvature changes in AIS participants with varied scoliotic severities and levels. A quasi-experimental study was conducted to evaluate the immediate effects of the same 30-minute digitalized 3D scoliosis correction intervention in fourteen AIS participants. Spinous process angles (SPAs) were quantified pre- and post-intervention using a portable ultrasound imaging system. The correction rate of each curve was calculated based on the pre- and post-intervention SPAs. The force application stability was also assessed to evaluate the device/protocol’s performance consistency in clinical settings. Paired t-tests, Spearman's rank-order correlations, and two-way mixed ANOVAs were conducted to examine the curvature changes, correlations between the correction rate and scoliotic level/severity, and the distributions and temporal variations of lateral passive force (LPF), respectively. Results: After the intervention, all participants (including 20 scoliotic curves) exhibited a significant reduction in curvature, regardless of the severity or level of scoliosis ( p < 0.05). A moderate negative correlation was observed between the correction rate and scoliotic severity (r _s = -0.489, p = 0.029). No significant correlation was observed between the correction rate and scoliotic level. Additionally, there were significantly slight decreases in the applied lateral forces over time ( p < 0.05), and smaller forces were applied to thoracic curves compared to those of the thoracolumbar/lumbar curves ( p < 0.001). Conclusions: This pilot study suggests the potential effectiveness of the developed new protocol for the immediate non-surgical reduction of scoliotic curvature in participants with AIS, as well as the feasibility of using a portable ultrasound imaging system for timely curvature assessments/follow-up. Trial registration No. : ChiCTR2400084383; Date: 15 May 2024.