If I have a thousand ideas and only one turns out to be good, I am satisfied.
-Alfred Nobel, as quoted by Ammanath Peethambaran, MS, CO, FAAOP, University of Michigan Orthotics & Prosthetics Center researcher.
The current fabrication method for a custom TLSO is a challenge, according to Ammanath Peethambaran, MS, CO, FAAOP, University of Michigan Orthotics & Prosthetics Center (UMPOC), a division of the University of Michigan Health System Department of Physical Medicine and Rehabilitation, Ann Arbor, because it requires measuring and casting the patient’s torso while he or she is lying in a trauma unit. The orthotist must maintain spinal stability while moving the patient into supine and prone positions, he says, and these motions increase the risk of further patient injury and discomfort. Because of these hazards, the options of either casting a mold or taking measurements and then outsourcing fabrication to a manufacturer didn’t satisfy Peethambaran. So the researcher and committee chairman looked for another option.
“The purpose of my study is to test a novel method of using a pre-existing computed tomography [CT] scan of the patient’s torso to create a custom…TLSO,” he explains. The plan is feasible since many patients undergo a CT scan soon after injury as a routine aspect of care, he says. Enhancements over current procedures include the generation of a mathematical model for a precise fit, as well as reductions in waiting time, cost, and environmental impact. “Using the CT scan with our methodology, we should be able to eliminate the need for a plaster mold,” he notes. “If successful, this study can lead to similar advances in creating other custom orthotic and prosthetic devices through CT scans.”
Peethambaran has spearheaded many projects aimed at untangling patient problems, including the development of a bivalve design cranial remolding helmet that adjusts to a baby’s growth. The development of the helmet also uses CT scan data.
Research collaboration is commonplace at U-M and leads to positive outcomes, according to Peethambaran. “I work with different departments like radiology, neuromechanics lab, vestibular lab, engineering…[and] orthopedics,” he says, in addition to the Department of Kinesiology and others. “Each investigator has [his or her] role,” he says, adding that “taking advantage of [each researcher’s] expertise is key [to a study’s] success.” But he cautions those considering research as a career not to attempt it “unless they are committed to the task” because research is “not an eight-to-five job.” He warns of long hours logged in the evenings and on weekends in the pursuit of answers. He argues that the O&P field “is still a craft and not a science,” and explains that in order to move toward the latter, “orthotic design and development must undergo a paradigm shift away from trial and error, toward a set of scientific principles.” He says he is “working toward that goal.” His patients, no doubt, are thankful.
Pam Martin can be reached at
Editor’s note: To read more about the collaborative efforts among researchers, practitioners, and students at universities that offer O&P educational programs and house clinical care facilities, watch for our May feature “Collaborative Dynamos: When the Sum Makes All the Parts Greater.”