Training and research application for c-spine ultrasound of an aging population.

描述（由申请人提供）：慢性颈椎损伤导致的颈部疼痛是最常见的肌肉骨骼疾病之一，特别是对于老龄化劳动力，颈部疼痛可能成为导致工作时间和生产力损失的重大职业问题。随着平均退休年龄的增加，为老年人修改适当的防护设备和活动的设计变得很重要，但需要更多关于这些活动的生物力学信息来适当地设计解决方案。目前，还没有方法可以实时评估人类受试者在工作场所以及其他活动和兴趣过程中的颈椎运动学。虽然CT和MRI被认为是评估导致颈部疼痛的病理解剖的最佳成像方式，但过大的尺寸和功率要求限制了这些技术实时评估人类受试者颈椎运动学和椎间盘移位的能力。我们建议开发一种立体超声系统，该系统可以为活跃的老年人群提供便携式、鲁棒性、动态、实时的颈椎成像，以确定职业活动的生物力学，并测量连续椎体和椎间盘移位的刚体运动学。双超声换能器图像的对齐和配准，结合刚体运动的假设，将用于计算连续颈椎的运动。首先，我们将验证由立体超声系统测量的刚体运动数据和椎间盘位移的准确性和可靠性，使用分离的人体颈椎节段安装在伺服液压多轴试验机中，承受代表性的动力和力矩。随后将测试完整的人类尸体，经受动态屈伸，侧向倾斜和轴向旋转力矩施加于头部和颈部。使用超声测量的刚体运动数据和椎间盘位移将与使用平面x线摄影测量的相同数据进行比较。使用立体超声和动态MRI测量的体内颈椎运动学和椎间盘位移将在人类志愿者弯曲/伸展，旋转和倾斜头部和颈部时进行比较。最后，将在健康志愿者中获得体内立体超声数据，这些志愿者在活跃的老龄化人群的职业活动中通常会遇到模拟惯性载荷，以建立超声评估导致颈椎损伤和慢性颈部疼痛的生物力学机制的能力。

DESCRIPTION (provided by applicant): Neck pain as a result of chronic cervical spine injury is one of the most common musculoskeletal complaints, especially for an aging workforce where neck pain can become a significant occupational issue leading to lost work time and productivity. As the average age of retirement increases it becomes important to modify the design of appropriate protective equipment and activities for older individuals, but more information is needed about the biomechanics of these activities to properly engineer solutions. Currently, there is no method to assess cervical spine kinematics in real time for human subjects in the course of their workplace and other activities and interests. While CT and MRI are considered the best imaging modalities to evaluate the pathoanatomy contributing to neck pain, excessive size and power requirements limit the ability of these technologies to assess cervical spine kinematics and intervertebral disc displacements in real time for human subjects. We propose to develop a stereographic ultrasound system that can provide portable, robust, dynamic, real-time imaging of the cervical spine in an active aging population to determine the biomechanics of occupational activities and to measure the rigid body kinematics of contiguous vertebrae and intervertebral disc displacements. The alignment and co-registration of images from dual ultrasound transducers, combined with an assumption of rigid body motion will be used to calculate the motion of contiguous cervical vertebrae. Initially we will validate the accuracy and reliability of the rigid body motion data and intervertebral disc displacements measured by the stereographic ultrasound system using isolated human cadaver cervical spine segments mounted in a servo-hydraulic, multi-axial testing machine subjected to representative dynamic forces and moments. This will be followed by testing intact human cadavers subjected to dynamic flexion/extension, lateral tilt and axial rotation moments applied to the head and neck. The rigid body motion data and intervertebral disc displacements measured using ultrasound will be compared to the same data measured using plane radiography. In-vivo cervical spine kinematics and intervertebral disc displacements measured using stereographic ultrasound and dynamic MRI will be compared in human volunteers as they flex/extend, rotate and tilt their head and neck. Finally in-vivo stereographic ultrasound data will be acquired in healthy volunteers subjected to simulated inertial loads typically encountered during the occupational activities of an active aging population to establish the ability of ultrasound to evaluate the biomechanical mechanisms contributing to cervical spine injury and chronic neck pain. . PUBLIC HEALTH RELEVANCE: Currently, there is no method to assess dynamic spine motion in-vivo as a result of repetitive forces applied to the cervical spine leading to neck injury that would occur in the workplace, especially for an aging workforce where neck pain can become a significant occupational issue leading to lost work time and productivity. As the average age of retirement increases it becomes important to modify the design of appropriate protective equipment and activities for older individuals, but more information is needed about the biomechanics of these activities to properly engineer solutions. Developing an inexpensive, portable and safe technique that can characterize the biomechanical etiology of cervical spine injury in an aging population without exposing subjects to radiation or requiring expensive MRI technology will have important societal benefits and could fundamentally change health recommendations to active seniors and design requirements for protective equipment in the workplace that would limit dynamic exposures in an active aging population.