INTRODUCTION: Thoracic-lumbar-sacral orthoses (TLSO) are the current gold-standard for conservatively managing the scoliotic deformity for idiopathic adolescent patients with a major curve Cobb angle between 20°-45°. Early detection and well-timed bracing are key factors in the treatment’s success. Scoliotic deformity can rapidly progress during the pubescent growth spurt. Current manufacturing methods for TLSO are labour-intensive with an approximate manufacturing time of 8-12 weeks. New time-efficient and cost-effective manufacturing methods are crucial to improve patient outcome and satisfaction. The research aimed to evaluate the reliability of 3D-printing for spinal orthoses.
METHODS: Four spinal orthoses were 3D-printed using an existing database of 3D surface scans from Queensland Children’s Hospital Spine Clinic (QCH-HREC-LNR/21/QCHQ/75249). The traditional manufacturing methods conducted by an orthotist were virtually replicated through 3D surface scanning and computer-aided-design modelling. The orthoses were 3D-printed using a Delta WASP Industrial X 4070 3D-printer and thermoplastic filament. Establishing suitable print settings to achieve a successful print was an iterative process. The constrained print settings, as well as, print time, print completion, print quality, print reliability, material waste and require post-processing for each orthosis was recorded.
RESULTS: Constraining the raster angle, infill pattern, infill density, print orientation and perimeter layers were important for improving print quality and reliability. Although an independent factor, bed adhesion had the most significant influence on print completion. Some patients were currently receiving bracing treatment through QCH. This allowed the fit, feel and cosmesis of the 3D-printed orthosis to be directly compared to a traditional orthosis.
DISCUSSION and CONCLUSION: Current challenges surrounding 3D-printing TLSO includes the complexity of 3D-printing thin-walled structures and selecting suitable material filament. This novel research shows promise for reducing manufacturing time, cost, and single-use material waste during spinal orthoses fabrication.