Optimization of skeletal configuration: studies of scoliosis correction biomechanics.

A scheme for optimizing configurations in models of skeletal structures is presented. Use of the scheme is illustrated through determination of biomechanically optimal correction of a right-thoracic scoliosis by passive brace and active muscle forces. The locations and magnitudes of the passive brace forces, and the trunk muscle groups and their corresponding contraction intensity magnitudes that would optimally correct the geometric deformities of the spine were determined. The results suggest that, from a biomechanical viewpoint, both brace and muscle forces are capable of substantial correction of a model thoracic scoliosis. However, comparison of model results with long-term clinical results suggests that even under optimal conditions it is unlikely that scoliosis can be fully corrected by passive brace forces or active muscle contractions.