Patient-specific spinal stiffness in AIS: a preoperative and noninvasive method

The clinical tests currently used to assess spinal biomechanics preoperatively are unable to assess true mechanical spinal stiffness. They rely on spinal displacement without considering the force required to deform a patient's spine. We propose a preoperative method for noninvasively quantifying the three-dimensional patient-specific stiffness of the spines of adolescent idiopathic scoliosis patients. The technique combines a novel clinical test with numerical optimization of a finite element model of the patient's spine. A pilot study conducted on five patients showed that the model was able to provide accurate 3D reconstruction of the spine's midline and predict the spine's stiffness for each patient in flexion, bending, and rotation. Statistically significant variation of spinal stiffness was observed between the patients. This result confirms that spinal biomechanics is patient-specific, which should be taken into consideration to individualize surgical treatment.