Patient-Specific Technology for In Vivo Assessment of 3-D Spinal Motion

用于 3D 脊柱运动体内评估的患者特定技术

• 批准号: 8732001
• 负责人: Avinash G. Patwardhan
• 金额: --
• 依托单位: EDWARD HINES JR VA HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8732001
• 关键词: 3-Dimensional; Affect; Aging; Algorithms; Analgesics; Anatomic Models; Anatomy; Articular Range of Motion; Automobile Driving; Back; Caring; Cervical; Clinical; Clinical Research; Coupling; Custom; Data; Databases; Deterioration; Development; Diagnosis; Diagnostic; Disease; Elements; Equipment Design; Exposure to; Facet joint structure; Flowcharts; Goals; Gold; Human; Image; Imaging Techniques; Implant; Intervention; Laboratories; Lateral; Left; Light; Low Back Pain; Magnetic Resonance Imaging; Manuals; Measurement; Measures; Medical Care Team; Methods; Mission; Modeling; Monitor; Motion; Muscle relaxants; Neck; Neck Pain; Neurologic; Neurologic Symptoms; Operative Surgical Procedures; Outcome; Outcome Measure; Pain; Pathology; Patient Care; Patients; Pattern; Physical Medicine; Physical Rehabilitation; Physicians; Positioning Attribute; Posture; Procedures; Process; Prosthesis; Radiation; Reconstructive Surgical Procedures; Research; Research Personnel; Rotation; Secondary to; Source; Specific qualifier value; Specimen; Spinal; Spinal Canal; Stenosis; Surgeon; Symptoms; System; Techniques; Technology; Testing; Translations; Validation; Vertebral column; Veterans; Work; abstracting; base; chronic pain; clinically relevant; cost effective; design; disability; functional disability; image registration; improved; in vivo; indexing; interest; kinematics; member; orthotics; patient population; public health relevance; reconstruction; research study; response; spine bone structure; tool; vertebra body

Abstract Purpose: The long-term goal of this research is to devise a non-invasive method to accurately assess 3-D in vivo spine kinematics to facilitate clinical studies aimed at improving diagnosis and assessment of treatments for degenerative spine conditions. Hypotheses: Our central hypothesis is that a patient-specific, MRI-based technique can be developed to accurately quantify continuous 3-D vertebral motions, facet joint motions, and spinal canal and foraminal stenosis utilizing tools that could be readily available to clinicians, and without excessive radiation exposure. The above hypothesis is based on our prior work in the laboratory, which has led to the development of a specimen-specific, 3-D kinematic assessment tool for human cadaveric studies of reconstructive surgeries. Specific Aims: (1) Development and ex vivo validation of a non-invasive, bi-planar fluoroscopic imaging technique for registration of vertebral anatomy. Working hypothesis 1: A bi-planar fluoroscopic registration method can be devised that, in conjunction with a 3-D MRI anatomic model, can accurately assess segmental kinematics at discrete positions as accurately as the laboratory technique that utilizes radiopaque spheres implanted on each vertebra. (2) Development and ex vivo validation of an algorithm for prediction of continuous kinematic data from segmental motions measured in discrete postures. Working hypothesis 2: Interpolation using 3-D spline functions can create an accurate prediction of continuous kinematic data based upon the bi-planar fluoroscopic data obtained for discrete positions. Research Plan: We will use a combination of experimental studies on human cadaveric spines, CT- and MRI- based anatomic models and bi-planar fluoroscopic imaging to develop a non-invasive method to acquire continuous 3-D kinematic data as specified in the aims of the proposed study. Our overall approach is illustrated in a flowchart. The first steps of the study are to: (1) design/refine an algorithm for registration of vertebral anatomy using bi-planar fluoroscopic imaging; and (2) design/refine an interpolation algorithm to predict continuous data from vertebral motion data acquired at discrete positions. These algorithms will be implemented on experimental data collected on human cadaveric spine specimens. The cadaveric experiments will simultaneously yield: (i) "Gold Standard" continuous kinematic data that is obtained using radiopaque spheres implanted on vertebral bodies, and an optoelectronic tracking system consisting of infrared light emitting diodes attached to each vertebra and IRED tracking cameras, and (ii) kinematic data derived from the proposed bi-planar registration technique in conjunction with an interpolation algorithm to derive continuous data. We will use the experimental data collected above to build and compare 3 specimen-specific models: (1) a CT-based gold standard model, (2) a CT-based model using bi-planar fluoroscopic image registration, and (3) an MRI-based model using bi-planar fluoroscopic image registration. Kinematic parameters calculated from the 3-D data will yield information on the accuracy and precision of the proposed non-invasive techniques. Significance: The contributions of the proposed study will include: (1) a robust, non-invasive kinematic assessment procedure utilizing tools that could be readily available to clinicians; and (2) a non-invasive method to acquire continuous 3-D kinematic data without excessive radiation; which in conjunction with the patient's 3-D anatomic model will allow dynamic assessment of axes of rotation, facet joint motions, spinal canal and foraminal stenosis, and in vivo 3-D disc deformations under functional loading scenarios.

摘要 目的：本研究的长期目标是设计一种非侵入性的方法来准确评估 活体脊柱运动学，以促进旨在改进诊断和治疗评估的临床研究 治疗脊椎退行性疾病。 假设：我们的中心假设是，可以开发一种针对患者的、基于MRI的技术来 准确量化连续的3-D椎体运动、小关节运动以及椎管和椎孔 使用临床医生可随时获得的工具进行狭窄，且不会过度辐射暴露。 上述假设是基于我们之前在实验室中的工作，这导致了一种 标本特定的三维运动学评估工具，用于人体身体重建手术的研究。 具体目标：(1)非侵入性双平面荧光成像的开发和体外验证 脊椎解剖配准技术。工作假设1：双平面透视配准 可以设计出一种方法，结合三维MRI解剖模型，可以准确地评估节段 离散位置的运动学与使用不透射线球体的实验室技术一样精确 植入到每个椎骨上。(2)一种用于预测的算法的开发和体外验证 在离散姿势下测量的分段运动的连续运动学数据。工作假设2： 使用3维样条函数的插补可以创建基于连续运动数据的准确预测 根据为离散位置获得的双平面透视数据。 研究计划：我们将结合对人类身体脊椎、CT和MRI的实验研究- 基于解剖模型和双平面透视成像开发一种非侵入性方法获取 连续的3-D运动学数据，如拟议研究的目标所规定的。我们的总体方法是 如流程图所示。研究的第一步是：(1)设计/改进一种配准算法 使用双平面透视成像进行脊椎解剖；以及(2)设计/改进内插算法以 从离散位置采集的脊椎运动数据预测连续数据。这些算法将是 基于在人类身体脊柱标本上收集的实验数据实施的。身体实验 将同时产生：(I)使用不透射线获得的“黄金标准”连续运动学数据 植入椎体的球体，以及由红外光组成的光电跟踪系统 发射连接到每个脊椎的二极管和IRED跟踪摄像机，以及(Ii)来自 提出的双平面配准技术与一种内插算法相结合，以获得连续的 数据。我们将使用上面收集的实验数据来建立和比较3个特定于标本的模型：(1)a 基于CT的金标准模型，(2)使用双平面透视图像配准的基于CT的模型，以及(3) 一种基于MRI的双面透视图像配准模型。运动学参数计算自 3D数据将提供有关拟议的非侵入性技术的准确性和精密度的信息。 意义：拟议研究的贡献将包括：(1)健壮、非侵入性运动学 使用临床医生容易获得的工具的评估程序；和(2)非侵入性方法 在不过度辐射的情况下获得连续的3-D运动学数据；这与患者的 三维解剖模型将允许动态评估旋转轴、小关节运动、椎管和 关节孔狭窄，以及在功能负荷情况下的活体三维椎间盘变形。