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: 9026513
• 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/9026513
• 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.

抽象的 目的：本研究的长期目标是设计一种非侵入性方法来准确评估 3D 环境 体内脊柱运动学促进旨在改善诊断和治疗评估的临床研究 用于脊柱退行性疾病。 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 3D 椎体运动、小关节运动以及椎管和椎间孔 利用临床医生容易获得的工具来治疗狭窄，并且无需过度辐射。 上述假设是基于我们之前在实验室的工作，这导致了一个 用于重建手术人体尸体研究的标本特异性 3D 运动学评估工具。 具体目标：(1) 非侵入性双平面荧光成像的开发和离体验证 椎体解剖结构配准技术。工作假设 1：双平面荧光镜配准 可以设计出一种方法，结合 3-D MRI 解剖模型，可以准确评估节段性 离散位置的运动学与利用不透射线球体的实验室技术一样精确 植入每个椎骨。 (2) 预测算法的开发和离体验证 来自以离散姿势测量的分段运动的连续运动学数据。工作假设 2： 使用 3-D 样条函数进行插值可以基于连续运动数据创建准确的预测 根据为离散位置获得的双平面荧光透视数据。 研究计划：我们将结合对人体尸体脊柱、CT 和 MRI 的实验研究 基于解剖模型和双平面荧光镜成像，开发一种非侵入性方法来获取 拟议研究目标中指定的连续 3D 运动学数据。我们的总体方法是 如流程图所示。研究的第一步是：（1）设计/完善注册算法 使用双平面荧光成像进行椎体解剖； (2) 设计/改进插值算法 从离散位置采集的椎体运动数据预测连续数据。这些算法将 根据从人类尸体脊柱标本上收集的实验数据进行实施。尸体实验 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 植入椎体上的球体以及由红外光组成的光电跟踪系统 连接到每个椎骨和 IRED 跟踪摄像机的发射二极管，以及 (ii) 从 提出了双平面配准技术与插值算法相结合来导出连续 数据。我们将使用上面收集的实验数据来构建和比较 3 个特定于样本的模型：（1）a 基于 CT 的金标准模型，(2) 使用双平面荧光透视图像配准的基于 CT 的模型，以及 (3) 使用双平面荧光镜图像配准的基于 MRI 的模型。运动参数计算公式为 3D 数据将产生有关所提出的非侵入性技术的准确性和精度的信息。 意义：拟议研究的贡献将包括：（1）稳健的、非侵入性的运动学 使用临床医生容易获得的工具进行评估程序； (2)非侵入性方法 无需过度辐射即可获取连续的 3D 运动数据；这与患者的 3D 解剖模型将允许动态评估旋转轴、小关节运动、椎管和 椎间孔狭窄，以及功能负载情况下的体内 3-D 椎间盘变形。

项目成果

Three-Dimensional Computed Tomography-Based Specimen-Specific Kinematic Model for Ex Vivo Assessment of Lumbar Neuroforaminal Space.

基于三维计算机断层扫描的标本特异性运动学模型，用于腰椎神经孔间隙的离体评估。

• DOI: 10.1097/brs.0000000000000959
• 发表时间: 2015
• 期刊: Spine
• 影响因子: 3
• 作者: Havey,RobertM;Goodsitt,Jeremy;Khayatzadeh,Saeed;Muriuki,Muturi;Potluri,Tejaswy;Voronov,LeonardI;Lomasney,LaurieM;Patwardhan,AvinashG
• 通讯作者: Patwardhan,AvinashG