Restoring symmetry is a primary goal of scoliosis surgery, added Dr. Widmann. However, symmetry is difficult to determine using x-rays, which don’t necessarily reveal how changes to the skeleton affect the shape of the body. “One of the most important things to patients and families is appearance,” he said. “That’s what they see and what the world sees. This technology is showing you the surface, and we hope it will help us align the goals of surgery even more closely with what patients and families want from the procedure.” Anatomical mapping could improve bracing therapy in the same way, he added.

HSS researchers also will be gathering Patient Reported Outcomes Measures (PROMs), such as mobility, personal appearance, ability to participate in sports and other aspects of daily life and more.

So far, 30 children have enrolled in the study, which Dr. Hillstrom and colleagues hope will ultimately include 2,000 patients over the next five years, as well as roughly 500 people with normal spines to serve as comparisons.

“Being able to use this technology to screen patients for scoliosis would be a big improvement over the current method, which uses a carpenter’s level on a patient’s back and has a very high rate of false-positives,” Dr. Widmann said. In other words, many children initially suspected of having scoliosis don’t have the condition — but doctors don’t know that until they take an x-ray. “You’re taking x-rays on a lot of kids who don’t need them, so we need a very reliable technology that correlates with x-rays so that you can safely decide if you need one or not. We’d love to have a better tool for this,” he adds.

The technology might also prove useful for other orthopedic applications, such as creating better casts for custom orthoses and prostheses or estimating inequality in the length of limbs — a problem that can lead to issues with gait, back pain and other complications. One medical application that combines these two technologies is cranio-fascial reconstructive surgery where both the shape of the external surface and the underlying bony architecture must be matched for proper function. But the uses are potentially much broader, Dr. Hillstrom said. “I think when you turn a group of experts loose on a new technology, they’re going to come up with a list of applications that we never dreamed of at the outset.”

Portions of the data collected from 3dMD will also be a part of a 3-year competitive research grant that was just awarded to HSS from the Cotrel Foundation entitled, “Use of Surface Topography for Screening and Outcome Evaluation of Adolescent Idiopathic Scoliosis”. Dr. Widmann serves as the principal investigator and Dr. Hillstrom as a co-investigator along with a team of pediatric Orthopedic surgeons, scientists, engineers, radiologists, pediatric sports medicine specialists, physical therapists, prosthetists/orthotists, pediatricians, and trainees.

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