Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study.
Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study.
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DOI：
10.1371/journal.pone.0135689
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Lorenzetti S
中科院分区：
文献类型：
--
作者：
Schmid S;Studer D;Hasler CC;Romkes J;Taylor WR;Brunner R;Lorenzetti S
尽管在研究人员和临床医生中，理解复杂脊柱畸形患者功能活动期间脊柱运动学的相关性是无可争议的，但使用基于皮肤标记的运动捕捉系统的证据仍然局限于少数研究，主要是在健康受试者中进行的，并且使用未经验证的标记配置。因此，目前的研究旨在探索先前开发的增强躯干标记集用于静态测量胸椎主动脉弓青少年特发性脊柱侧凸患者脊柱弯曲角的有效性。此外，还研究了标记点放置不准确对曲率角计算的影响。10例患者（Cobb角：44.4±17.7度）在选择的棘突上放置放射性不透明标记物，并进行标准双平面x线片检查。随后，用反射标记代替不透明标记，使用Vicon运动捕捉系统对患者进行静态测量。根据椎体面积中心和不透射线标记物以及反射标记物的三维位置，计算矢状面和额状面胸椎/腰椎和胸椎曲率角。为了研究曲率角估计的精度，对各参数进行了线性回归分析。使用线性回归分析在放射不透明标记和棘突衍生的曲率角度之间探讨不准确标记放置的影响。结果表明，矢状面曲率角的测量精度合理，而在正面面，曲率角被系统性地低估，这主要是由于脊柱侧凸的位置和结构变形。标记物放置不准确对胸腰椎的影响大于胸椎弯曲角度。建议将脊柱曲率测量纳入基于标记物的临床步态分析方案，以便更深入地了解健康和病理脊柱在动态情况下的生物力学行为，并全面评估治疗效果。
Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated. Ten patients (Cobb angle: 44.4±17.7 degrees) were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar / lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles. The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar / lumbar than thoracic curvature angles. It is suggested that spinal curvature measurements are included in marker-based clinical gait analysis protocols in order to enable a deeper understanding of the biomechanical behavior of the healthy and pathological spine in dynamic situations as well as to comprehensively evaluate treatment effects.