A patient-specific computational technique to predict spine injury risks associated with physical activities

项目概要/摘要 椎骨骨折是最常见的骨质疏松性骨折类型。脊柱也是最常见的部位 骨转移，导致病理性椎体骨折。虽然进行日常生活活动是 健康衰老的重要组成部分，病理性和非病理性椎体骨折可能发生在这些过程中 转移或骨质疏松脊柱的活动。这些骨折会引起疼痛和神经系统表现， 影响生活质量。目前，尚无客观的临床技术可以评估骨折风险 与身体活动有关。为了填补这一空白，我们提出了一种针对患者的计算技术 定量评估与体育活动相关的脊柱损伤风险。这种新颖的方法将使 临床医生向老年人可靠地推荐安全和个性化的活动。为了实现这一目标，我们 将使用视频运动分析从老年患者群体中获取运动和肌肉活动结果。 这些数据将用作尸体腰椎运动学分析和机械测试的输入 脊柱，创建并验证我们的计算模型。该项目的基本原理是 QCT/FEA 可以模仿身体活动的过程将能够减少椎骨骨折并提高生活质量 老年患者群体。我们的长期目标是开发可靠的计算技术，以便更早地实现 患有肌肉骨骼疾病的老年患者的损伤风险预测。我们的总体目标是 应用程序，旨在开发基于患者特定的定量计算机断层扫描的有限元分析 (QCT/FEA) 方法可以评估脊柱的运动学和骨折特征， 估计体力活动的骨折风险。为了实现总体目标，以下三个独立的 将实现的具体目标：1）获得腰部运动范围和肌肉反应结果 五次身体运动期间的老年患者群体； 2）对尸体脊柱进行运动学测试 在身体运动过程中使用一种新颖的方法测量椎间盘内压力；还有机械的 对脊柱节段进行测试以测量骨折时椎间盘内的压力； 3) 开发和验证 腰椎 QCT/FEA 模型，用于估计脊柱损伤风险。 这项研究将导致发展 可以分配与身体活动相关的风险评分的计算工具。 此外，这项工作将 为未来 R01 拨款提案提供初步数据，以预测与身体相关的骨折风险 患者群体的运动和锻炼。

PROJECT SUMMARY/ABSTRACT Vertebral fracture is the most common type of osteoporotic fracture. Spine is also the most common site of bone metastasis, leading to pathologic vertebral fractures. While performing activities of daily living is an essential part of healthy aging, pathologic and non-pathologic vertebral fractures can occur during these activities in metastatic or osteoporotic spines. These fractures cause pain and neurologic manifestations, affecting quality of life. Currently, there is no objective clinical technique that can assess bone fracture risks associated with physical activities. To fill the gap, we propose a patient-specific computational technique to quantitatively evaluate spine injury risks associated with physical activities. This novel approach will enable clinicians to reliably recommend safe and individualized activities to elderly populations. To achieve this, we will obtain motions and muscle activity outcomes from an elderly patient cohort using video motion analysis. These data will be used as input for kinematic motion analyses and mechanical testing on cadaveric lumbar spines, to create and validate our computational models. The rationale for this project is that a QCT/FEA process that can mimic physical activities will be able to reduce vertebral fractures and improve quality of life in elderly patient populations. Our long-term goal is to develop reliable computational techniques to enable earlier injury risk predictions in elderly patients with musculoskeletal diseases. Our overall objective, in this application, is to develop a patient-specific quantitative computed tomography-based finite element analysis (QCT/FEA) method that can assess both kinematic motions and fracture characteristics of the spine, to estimate fracture risks of physical activities. To achieve the overall objective, the following three independent specific aims will be accomplished: 1) to obtain lumbar range of motion and muscle response outcomes in an elderly patient population during five physical movements; 2) to perform kinematic testing on cadaveric spines to measure intradiscal pressures –using a novel approach– during physical movements; and also mechanical testing on spine segments to measure intradiscal pressure at fracture; and 3) to develop and validate QCT/FEA models of the lumbar spine to estimate spine injury risks. This research will lead to the development of a computational tool that can assign a risk score associated with physical activities. Further, this work will provide preliminary data for future R01 grant proposals to predict fracture risks associated with physical movements and exercises in patient populations.