Scoliosis is a highly complex 3D musculoskeletal disorder (MSD) of the spine that greatly affects the patient’s health and quality of life, including functional limitations with secondary complications such as respiratory and circulatory dysfunction, pain, as well as cosmetic changes. Scoliosis affects 0.47–5.20% of the global population, and almost 80-90% of the cases develop for an unknown reason (idiopathic), with an alarming estimated prevalence of 36 million new patients worldwide by 2050 according to the World Health Organisation. The main drawback of traditional radiographic (RAD) methods in AIS assessment is their harmful effect on what is an often young, and hence extremely vulnerable population, especially due to multiple radiation exposures while monitoring progression of the disease. As a result, patients are cumulatively exposed to a substantial amount of ionizing radiation, and each exposure increases the risk for malignancy development later in life. The clinical goal and priority are therefore to avoid or reduce application of those methods in AIS monitoring with a clear preference for non-invasive techniques based on visual examination of the patient’s trunk and external deformity measures.
The overarching aim and objectives of the project were to address the challenges associated to assessment and screening of Adolescent Idiopathic Scoliosis (AIS) in a non-invasive manner by investigating the level of accuracy, precision and reliability of optical software solutions (ScolioSIM1.0) developed by the fellow, to validate and improve the accuracy of the Generic Spinal Model (GSM) against radiographic modalities, to implement it into the clinical environment, and to extend it for online AIS monitoring (ScolioSIM2.0→ScolioMedIS).
The achievement of the proposed aim and objectives required a detailed and multidisciplinary approach and involvement of patients, clinicians and experimental study in clinical environment. In terms of results, the ScolioSIM project led to a: 1) better understanding of correlation between spinal deformities and external appearance of the subject with AIS, 2) new protocol for more precise data collection, 3) improved ScolioSIM tool, 4) ScolioMedIS platform for e-monitoring and reporting of AIS deformity and 5) further funding for translational research and development.
The development of better diagnosis and management of AIS as a research focus of ScolioSIM will continue to contribute to the goal of the European Innovation partnership on Active and Healthy Ageing and increasing the quality of life. The ScolioSIM project and its results tackled H2020 EU societal challenges SC1-BHC-06-2020: “Digital Diagnostics - Developing Tools for Supporting Clinical Decisions by Integrating Various Diagnostic Data”, SC1-DTH-13-2020: “Implementation research for scaling up and transfer of innovative solutions involving digital tools for people-centred care”, by development algorithms and tools for innovative 3D digital diagnosis, rapid screening, preventing disabilities among children and archiving datasets on AIS patients. These challenges will be fully addressed once translation of ScolioSIM findings to the low-cost device is completed.
