Validation of a noninvasive technique to precisely measure in vivo three-dimensional cervical spine movement.
Validation of a noninvasive technique to precisely measure in vivo three-dimensional cervical spine movement.
复制标题
验证非侵入性技术以精确测量体内三维颈椎运动。
DOI：
10.1097/brs.0b013e31820b7e2f
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发表时间：
2011-03-15
期刊：
影响因子：
3
通讯作者：
Kang JD
中科院分区：
文献类型：
--
作者：
Anderst WJ;Baillargeon E;Donaldson WF 3rd;Lee JY;Kang JD
功能负荷期间的活体验证。为了确定基于模型的跟踪技术的准确性和可重复性，该技术结合特定对象的CT模型和高速双平面X射线图像来测量活体颈椎运动的三维(3D)。由于无法将测量设备直接连接到单个椎骨，在生理负荷过程中很难在体内获得准确的3D脊柱运动。以前的测量系统受到二维(2D)结果和/或手动识别解剖标志的需要的限制，导致结果不可靠和不准确。所有以前的技术都缺乏在动态功能加载过程中捕获真实3D运动的能力。在ACDF手术中，三名受试者将直径1.0 mm的钽珠植入他们融合的和邻近的椎体中。手术后获得高分辨率CT扫描，并用于创建每个颈椎的特定对象3D模型。在受试者术后6个月进行屈曲/伸展和轴向旋转运动的同时，以每秒30帧的速度收集双平面X光片。从动态RSA获得的个体骨骼运动、椎间运动学和关节运动学被作为评估基于模型的跟踪技术的准确性的金标准。在未融合骨和融合骨中，单个骨的平均跟踪精度分别为0.19 mm和0.33 mm。测量融合节段和邻近节段的三维关节运动学的精度，平移平均为0.4 mm，旋转平均为1.1°，而融合前后关节盘高度的测量精度为0.2 mm~0.4 mm。与重复追踪同一试验相关的3D关节运动学的变异性是平移0.02 mm，旋转0.06°。在功能负荷过程中，可以以亚毫米精度在活体内精确测量3D颈椎运动，而不需要植入钢珠。融合内固定不会降低运动学和关节运动学结果的准确性。基于模型的半自动跟踪技术具有很好的重复性。
In vivo validation during functional loading. To determine the accuracy and repeatability of a model-based tracking technique that combines subject-specific CT models and high-speed biplane X-ray images to measure three-dimensional (3D) in vivo cervical spine motion. Accurate 3D spine motion is difficult to obtain in vivo during physiological loading due to the inability to directly attach measurement equipment to individual vertebrae. Previous measurement systems were limited by two-dimensional (2D) results and/or their need for manual identification of anatomical landmarks, precipitating unreliable and inaccurate results. All previous techniques lack the ability to capture true 3D motion during dynamic functional loading. Three subjects had 1.0 mm diameter tantalum beads implanted into their fused and adjacent vertebrae during ACDF surgery. High resolution CT scans were obtained following surgery and used to create subject-specific 3D models of each cervical vertebra. Biplane X-rays were collected at 30 frames per second while the subjects performed flexion/extension and axial rotation movements six months after surgery. Individual bone motion, intervertebral kinematics, and arthrokinematics derived from dynamic RSA served as a gold standard to evaluate the accuracy of the model-based tracking technique. Individual bones were tracked with an average precision of 0.19 mm and 0.33 mm in non-fused and fused bones, respectively. Precision in measuring 3D joint kinematics in fused and adjacent segments averaged 0.4 mm for translations and 1.1° for rotations, while anterior and posterior disc height above and below the fusion were measured with a precision ranging between 0.2 mm and 0.4 mm. The variability in 3D joint kinematics associated with tracking the same trial repeatedly was 0.02 mm in translation and 0.06° in rotation. 3D cervical spine motion can be precisely measured in vivo with sub-millimeter accuracy during functional loading without the need for bead implantation. Fusion instrumentation did not diminish the accuracy of kinematic and arthrokinematic results. The semi-automated model-based tracking technique has excellent repeatability.