Image-driven subject-specific spine models

英国有数百万人患有脊柱或背部问题。这些问题在社会和经济上都造成了很高的代价，我们需要找到预防或解决这些问题的办法。但要实现这一目标，我们需要高质量的工具，帮助我们了解健康的脊柱是如何运作的，以及当它们出现问题时会发生什么。我们的项目是关于开发和测试"图像驱动的特定主题的脊柱模型"，它有可能提供一个工具，用于确定脊柱中的力。确定单个脊柱正在经历的力对于理解脊柱功能至关重要。不正常的力量与许多问题有关，包括手动操作损伤，椎间盘退变和背痛。然而，直接在脊柱中测量力是非常侵入性的。模型提供了一种非侵入性的方法，但为了提供准确的评估，它们需要包括有关个人的信息（特定于受试者）。由于每个人都有独特的解剖结构和组织，并且使用不同的脊柱，因此受试者特异性至关重要。我们已经成功地试行了一种用于测量脊柱力的建模方法，其中包括受试者特异性解剖结构和脊柱运动。该方法涉及使用医学成像不仅提供有关个人解剖结构的信息，而且还观察活动期间脊柱的运动。然后将观察到的运动应用于模型并计算力。利用脊柱运动来驱动模型是一个相对较新的创新，我们和其他小组已经证明是可行的。它有几个好处，包括能够识别脊柱内的局部力量，避免建模未知的肌肉力量。在拟议的项目中，我们的第一个目标是通过在我们的模型中包括特定于受试者的组织属性来扩展我们的试点工作。很少有脊柱模型包括受试者特定的组织特性。然而，我们知道个体之间的组织差异很大，具有特定于对象的特性将提高我们模型的准确性。因此，我们将开发一种从医学成像数据中估计组织特性的方法。将根据已测试的样本创建模型，以确定其机械响应。然后，我们将学习如何使用图像数据来设置组织属性，使我们的模型能够重现测量的机械响应。我们随后的目标是严格测试我们的图像驱动的特定对象建模方法，并将其开发为真实的应用。特定对象模型在确定力方面有许多潜在的应用，但这些应用的误差容限不同。因此，我们将评估和分析模型中误差的大小和来源。最初，我们将使用可以进行机械测试的试样，以便我们可以将模型结果与试样中测量的力进行比较。我们将使用这些信息来改进我们从人们那里收集数据的方法，然后我们将使用志愿者对我们的方法进行更多的测试，我们将要求他们执行指定的活动。我们将再次比较我们的模型结果与预期的力。我们的图像驱动的特定主题脊柱模型的开发和测试将为确定脊柱中的力提供新的工具。它还将为测量和建模脊柱运动以及量化脊柱组织的特性提供新的工具。但更重要的是，我们的项目将为真实的了解脊柱的功能以及如何更有效地预防或治疗脊柱问题铺平道路。

Many millions of people in the UK suffer problems with their spine or back. These problems incur a very high cost, both socially and economically, and we need to find ways of preventing or solving them. But to achieve this, we need high-quality tools that can help us understand how healthy spines function and what happens when they develop problems. Our project is concerned with developing and testing 'image-driven subject-specific spine models' which have the potential to provide a tool for determining forces in the spine.Determining the force that an individual spine is experiencing is essential for understanding spine function. Abnormal forces are linked to many problems, including manual handling injury, disc degeneration, and back pain. Measuring force directly in the spine, however, is very invasive. Models provide a non-invasive method but, to provide accurate assessments, they need to include information about the individual (subject-specific). The subject-specificity is essential because everyone has unique anatomy and tissues, and uses their spines differently.We have successfully piloted a modelling approach for measuring spinal force that includes subject-specific anatomy and spinal motion. The method involves using medical imaging not only to provide information on an individual's anatomy but also to observe the movement of their spine during activity. The observed motion is then applied to the model and force calculated. The use of spinal motion to drive models is a relatively recent innovation that we, and other groups, have shown to be feasible. It has several benefits, including the ability to identify localised forces within the spine and avoiding the need to model unknown muscle forces.In the proposed project, our first goal is to extend our pilot work by including subject-specific tissue properties in our models. Very few models of the spine include subject-specific tissue properties. However, we know tissues vary a lot between individuals and having subject-specific properties will increase the accuracy of our models. We will, therefore, develop a method for estimating tissue properties from medical imaging data. Models will be created from specimens that have been tested to determine their mechanical response. We will then learn how we can use the image data to set tissue properties that allow our models to reproduce the measured mechanical response.Our subsequent goals are to test our image-driven subject-specific modelling method rigorously and develop them for real application. Subject-specific models have many potential applications for determining forces, but these applications differ in their tolerance for error. We will, therefore, evaluate and characterise the magnitude and sources of error in our models. Initially, we will use specimens which can be mechanically tested so that we can compare model results to forces measured in the specimens. We will use this information to improve our methods for collecting data from people then we will perform more testing of our method using volunteers who we will ask to perform specified activities. Again we will compare our model results to the expected forces.The development and testing of our image-driven subject-specific spine models will provide a new tool for determining forces in the spine. It will also provide new tools for measuring and modelling spine movement and quantifying the properties of the spinal tissues. But more than this, our project will pave the way to a real understanding of how the spine functions and how problems in the spine can be prevented or treated more effectively.