脊椎側彎目前在全球仍是常見的問題，根據國內外統計脊椎側彎人口約佔總人口數的3%，其中有八成的患者屬不明因性的脊椎側彎，此種側彎好發於成長階段的青少年，故又稱為青少年原發性脊椎側彎（Adolescent Idiopathic Scoliosis, AIS）。大多數側彎患者在治療上除了進行運動治療外，亦會穿戴側彎矯正背架以矯正側彎角度（Cobb’s angle），然而傳統背架大多較為厚重悶熱，且製程步驟較為繁瑣也容易產生誤差，故本研究透過電腦輔助設計與製造（Computer aided design/manufacturing, CAD/CAM）方式設計一種針對青少年原發性脊椎側彎患者所穿戴的側彎背架，旨在改善傳統側彎背架的不適感並將修模誤差降至最低，同時給予患者適當的矯正效果。
背架的設計理念參考了波士頓背架與里戈-謝諾背架的矯正原理，過程中全程使用數位化的方式進行設計，搭配三維建模技術與修模軟體將修模過程中的誤差降至最低，最終使用三維列印技術（Three Dimensions Printing Technology）製造側彎背架。
結果顯示，本研究所建構之側彎背架可以精準地對上患者軀幹的各特徵點，且避開了許多容易引起患者不適之部位，側彎背架本身的多孔洞設計達到了輕量、透氣等效果，此外在矯正效果上，穿戴本研究之側彎背架可使患者在冠狀面上的頭部偏斜角度從3.82度減少至2.19度，側彎角度從29.69度減少至13.05度，以上結果初步驗證了本研究所建構之側彎背架對於脊椎側彎患者擁有正向的矯正效果。
本研究未來將持續增加患者樣本數，並加入矢狀面的X光片進行矯正效果的探討，以獲得更為客觀的統計數據，過程中亦將持續推廣數位化側彎背架並同時改善修模策略，嘗試更多的三維列印技術，致力於製造出更為舒適又具有矯正效果的側彎背架，幫助更多因側彎而苦的孩童。

At the present day, scoliosis is still a common problem in the world. According to domestic and foreign statistics, the population of scoliosis accounted for about 3% of the total population. Among them, 80% of patients had unexplained scoliosis. This type of scoliosis usually occurs in adolescents who are growing up, so it is also called Adolescent Idiopathic Scoliosis (AIS). In addition to exercise therapy, most patients with AIS also wear orthoses to correct the Cobb's angle. However, traditional scoliosis braces were mostly thick and stuffy, and the process steps were more cumbersome and prone to errors. Therefore, this study used computer aided design/manufacturing (CAD/CAM) to design a scoliosis brace for patients with AIS. The aim of this study was to improve the discomfort of the traditional scoliosis braces and minimize the error of the remodeling, while giving the patient an appropriate correction effect.
The design concept of the scoliosis brace referred to the correction principle of the Boston brace and the Rigo-Chêneau brace. The digital method was used throughout the process to design the scoliosis brace, and the three-dimensions modeling technology and remodeling software were used to reduce the error in the remodeling process. Lastly, we used three-dimensions printing technology to manufacture our scoliosis brace.
The results showed that the scoliosis brace constructed in this study could accurately align the characteristic points of the patient’s torso and avoided many parts that were likely to cause discomfort to the patients. The perforated design of the scoliosis brace achieved the effects of lightweight and ventilation. In addition, in terms of the correction effect, wearing the scoliosis brace of this study could reduce the patient's head deflection angle on the coronal plane from 3.82 degrees to 2.19 degrees, and the cobb's angle from 29.69 degrees to 13.05 degrees. The above results preliminarily verified that the scoliosis brace constructed in this study had a positive correction effect for patients with scoliosis.
In the future, we will continue to increase the number of patient samples, and add sagittal plane X-rays to discuss the correction effect, so as to obtain more objective statistical data. In the process, we will continue to promote the digitally manufactured scoliosis brace and improve the remodeling strategy at the same time, try more three-dimensional printing technology, and strive to create a more comfortable and corrective scoliosis brace to help more children suffered by scoliosis.

[1]J.A. Ashton-Miller, A.B. Schultz (1988). Biomechanics of the human spine and trunk. Exerc Sport Sci Rev, 16, 169-204.
[2]R. Carola, J.P. Harley, C.R. Noback (1992). Human anatomy and physiology.
[3]A.P. Schnuerer, P.A. Julio Gallego, M.D. Cristie Manuel (2005). Anatomy of the Spine & Related Structures.
[4]T. Hines (2018). Anatomy of the Spine. Mayfield Brain & Spine.
[5]A. Fujiwara, T.H. Lim, H.S. An, N. Tanaka, C.H. Jeon, G.B. Andersson, V.M. Haughton (2000). The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility the lumbar spine. Spine, 25(23), 3036-3044.
[6]L.M. Ruberte, R.N. Natarajan, G.B. Andersson (2009). Influence of single-level lumbar degenerative disc disease on the behavior of the adjacent segments – a finite element model study. Journal of biomechanics, 42(3), 341-348.
[7]A.L. Kuznia, A.K. Hernandez, L.U. Lee (2020). Adolescent Idiopathic Scoliosis: Common Questions and Answers. Am Fam Physician, 101(1), 19-23.
[8]K. Allen Greiner (2002). Adolescent idiopathic scoliosis: radiologic decision-making. American Family Physician, 65(9), 1817-1822.
[9]M.H. Horng, C.P. Kuok, M.J. Fu, C.J. Lin, Y.N. Sun (2019). Cobb Angle Measurement of Spine from X-Ray Images Using Convolutional Neural Network. Computational and Mathematical Methods in Medicine, vol. 2019, ID. 6357171.
[10]U. Nilsonne, K.D. Lundgren (1968). Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand, 39(4), 456-65.
[11]K. Pehrsson, S. Larsson, A. Oden, A. Nachemsonm (1992). Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976), 17(9), 1091-6.
[12]POSNA (2020) Surgical Treatment for Scoliosis. OrthoInfo. [https://orthoinfo.aaos.org/en/treatment/surgical-treatment-for-scoliosis/]
[13]G.D. MacEwen, W.P. Bunnell, K. Sriram (1975). Acute neurological complications in the treatment of scoliosis. A report of the Scoliosis Research Society. J Bone Joint Surg Am, 57(3), 404-8.
[14]L. Kalichman, L. Kendelker, T. Bezalel (2016). Bracing and exercise-based treatment for idiopathic scoliosis. Journal of bodywork and movement therapies, 20(1), 56-64.
[15]K. Dobosiewicz, J. Durmala, T. Kotwicki (2008). Dobosiewicz method physiotherapy for idiopathic scoliosis. Studies in health technology and informatics, 135, 228-236.
[16]K.M. Fabian, K. Rożek-Piechura (2014). Exercise tolerance and selected motor skills in young females with idiopathic scoliosis treated with different physiotherapeutic methods. Ortopedia, traumatologia, rehabilitacja, 16(5), 507-522.
[17]C. Fusco, F. Zaina, S. Atanasio, M. Romano, A. Negrini, S. Negrini (2011). Physical exercises in the treatment of adolescent idiopathic scoliosis: an updated systematic review. Physiotherapy theory and practice, 27(1), 80-114.
[18]W. A. den Boer, P. G. Anderson, J. v Limbeek, M. A. Kooijman (1999). Treatment of idiopathic scoliosis with side-shift therapy: an initial comparison with a brace treatment historical cohort. European Spine Journal, 8(5), 406-410.
[19]C. Lehnert-Schroth (1992). Introduction to the three-dimensional scoliosis treatmentaccording to Schroth. Physiotherapy, 78(11), 810-815.
[20]S. Otman, N. Kose, Y. Yakut (2005). The efficacy of Schroth's 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Neurosciences (Riyadh), 10(4), 277-83.
[21]M. Romano, A. Negrini, S. Parzini, S. Negrini (2008). Scientific Exercises Approach to Scoliosis (SEAS): efficacy, efficiency and innovation. Studies in health technology and informatics, 135, 191-207.
[22]S. Negrini, A. Negrini, M. Romano, N. Verzini, A. Negrini, S. Parzini (2006). A controlled prospective study on the efficacy of SEAS. 02 exercises in preparation to bracing for idiopathic scoliosis. Studies in health technology and informatics, 123, 519.
[23]姚又誠（2020）。脊椎側彎惡化知多少。骨科線上。[https://sites.google.com/view/bonenews/]
[24]J.E. Lonstein, J.M. Carlson (1984). The prediction of curve progression in untreated idiopathic scoliosis during growth. J. Bone Joint Surg. Am., 66, 1061-1071.
[25]T. Yrjonen, M. Ylikoski (2006). Effect of growth velocity on the progression of adolescent idiopathic scoliosis in boys. Journal of pediatric orthopedics - part B, 15(5), 311-315.
[26]J. Biondi, D.S. Weiner, D. Bethem, J.F. Reed III (1985). Correlation of Risser Sign and Bone Age Determination in Adolescent Idiopathic Scoliosis. Journal of Pediatric Orthopedics, 5, 697-701.
[27]O. Friberg (1983). Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine, 8, 643-651.
[28]J.P. Gofton (1985). Persistent low back pain and leg length disparity. J Rheumatol, 12, 747-750.
[29]R.S. Young, P.D. Andrew, G.S. Cummings (2000). Effect of simulating leg length inequality on pelvic torsion and trunk mobility. Gait Posture, 11, 217-223.
[30]K.F. Zabjek, M.A. Leroux, C. Coillard, X. Martinez, J. Griffet, G. Simard, C.H. Rivard (2001). Acute postural adaptation induced by shoe lift in idiopathic scoliosis patients. Eur Spine J, 10, 107-113.
[31]J.W. Raczkowski, B. Daniszewska, K. Zolynski (2010). Functional scoliosis caused by leg length discrepancy. Archives of Medical Science, 6(3), 393-398.
[32]R.S. Fayssoux, R.H. Cho, M.J. Herman (2010). A history of bracing for idiopathic scoliosis in North America. Clin Orthop Relat Res, 468, 654-664.
[33]A.L. Nachemson, L.E. Peterson (1995). Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. The Journal of Bone and Joint Surgery, 77-A, 6.
[34]J.W. Wiley, J.D. Thomson, T.M. Mitchell, B.G. Smith, , J.V. Banta (2000). Effectiveness of The Boston Brace in Treatment of Large Curves in Adolescent Idiopathic Scoliosis. SPINE, 25(18), 2326-2332.
[35]J.B. Means, M.T. Hresko, J.E. Hall, D. Hedequist, L. Karlin, J. Miller, R. Miller, M. Magin, C. McCarthy , M. Cassella, K. Ryan (2003). Reference manual for the Boston Scoliosis Brace. BOSTON BRACE INTERNATIONAL, INC.
[36]M.D. Rigo, M. Villagrasa, D. Gallo (2010). A specific scoliosis classification correlating with brace treatment: Description and reliability. Scoliosis , 5(1), 1.
[37]D. Ovadia, S. Eylon, A. Mashiah, S. Wientroub, E.D. Lebel (2012). Factors associated with the success of the Rigo System Chêneau brace in treating mild to moderate adolescent idiopathic scoliosis. J Child Orthop, 6(4), 327-331.
[38]M.Q. Fang, C. Wang, G.H. Xiang, C. Lou, N.F. Tian, H.Z. Xu (2015). Long-term effects of the Chêneau brace on coronal and sagittal alignment in adolescent idiopathic scoliosis. J Neurosurg Spine, 23(4), 505-509.
[39]J. Dubousset (1992). Importance of the three-dimensional concept in the treatment of scoliosis deformities. Dansereau J ed. International Symposium on 3D Scoliotic Deformities joined with the VII International Symposium on Spinal Deformities and Surface Topography. Gustav Fisher Verlag, 302-311.
[40]M. Rigo, M. Jelačić (2017). Brace technology thematic series: the 3D Rigo Chêneau-type brace. Scoliosis and Spinal Disorders, 12(10).
[41]royal national orthopaedic hospital. [http://www.rnohguide.com]
[42]phrozen3d. [https://phrozen3d.com/]
[43]PING Design and Made In Taiwan. [https://www.linkinfactory.com/]
[44]M.K. Minsk, K.D. Venuti, G.L. Daumit, P.D. Sponseller (2017). Effectiveness of the Rigo Chêneau versus Boston-style orthoses for adolescent idiopathic scoliosis: a retrospective study. Scoliosis and Spinal Disorders, 12(7).