Background
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that affects adolescents aged 10-18 years. Non-operative treatment for moderate spinal curves (25 ° to 45°) commonly involves bracing. Recently, the application of three-dimensional technologies in brace design, development, and evaluation has increased. However, there is a lack of objective and transparent criteria for quality of care.
Objectives
To identify and summarize the available evidence on the methodology and application of three-dimensional technology in brace design and development for AIS brace treatment.
Methods
A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Clinical, computational, or technological studies describing the methodology or application of three-dimensional technology in AIS brace treatment were included. Searches were performed on 10th of November 2025 in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, Embase, and Google Scholar. Methodological quality of the clinical studies was assessed using Critical Appraisal Skills Programme checklists.
Results
Forty-two studies were included (18 clinical, 16 computational and 8 technical). Publications increased after 2018, reflecting growing interest in three-dimensional technologies. Clinical studies predominantly evaluated short-term (≤1 year) radiographic outcomes, with substantial heterogeneity in outcome definitions and thresholds for clinical relevance. Computational and technical studies focused on biomechanical modelling, design feasibility, or process performance. Integration between clinical, computational and technical evaluation approaches was limited.
Conclusion
Three-dimensional technologies in brace design and development are increasingly applied, but evidence is characterized by heterogeneous outcome definitions, limited temporal scope and fragmented validation approaches. Standardised outcome measures and integrated clinical and technological evaluation frameworks are needed to enable robust validation, support long-term (cost-)effectiveness assessment, and facilitate meaningful clinical translation and implementation in routine orthotic practice.
