Novel Analytical Tools for 3 Dimensional Imaging Studies on Spinal Manipulation

描述（由申请人提供）：拟议项目的总体目标是将基础科学脊柱生物力学领域开发的分析技术转化为临床研究，以更好地了解脊柱推拿治疗对下背部的影响 拟议项目的具体目标是：（1a）开发一种使用3D CT/MRI模型进行小关节运动学分析的分析工具，并使用尸体标本对其进行验证，（1b）验证一种使用尸体特定3D CT/MRI模型测量小关节间隙空间的分析工具，（2）开发一种新的分析工具来测量神经孔和神经管的三维尺寸，并使用人尸体标本验证这些测量的准确性，和（3）将这些新的和其他现有的独立分析工具整合到一个用户友好的软件包中，并在网络上免费提供给脊柱推拿治疗的大型多站点临床成像研究的研究人员和整个研究团体。将开发使用3D CT/MRI模型和基于小平面的坐标系的小平面运动学的新分析工具。利用CT/MR结合的三维模型，将开发一种用于三维椎间孔和椎管分析的新方法。为脊柱生物力学开发的最先进技术也将适用于脊柱推拿的临床研究。分析将包括：三维脊柱对线，脊柱运动节段在屈曲、伸展、侧弯和轴向旋转期间的三维运动学。这些分析将有助于了解脊柱结构与功能的关系以及脊柱推拿前后脊柱结构和运动的变化。将使用尸体标本对拟议项目中开发的新技术进行验证，并将为脊柱操作的严格研究提供有关各项技术准确性的数据。基线信息将用于把握度分析，以评估未来研究设计的样本量。将开发和适用于脊柱推拿效果研究的分析方法集成在一个软件包中，以便即使不熟悉数学分析的研究人员也可以使用这些分析方法。该软件包将通过一个专门的网站向公众发布。预计拟议研究的结果对于评估其他肌肉骨骼疾病的其他形式的补充和替代医学（CAM）同样有效。

DESCRIPTION (provided by applicant): The overall goals of the proposed project are to translate analytical techniques developed in the field of basic science spine biomechanics to clinical studies for better understanding of the effects of spinal manipulative therapy on low back pain The specific aims of the proposed project are: (1a) To develop an analytical tool for facet kinematics analysis using 3D CT/MRI models and to validate it with cadaveric specimens, (1b) To validate an analytical tool to measure facet gap space using cadaveric specimen-specific 3D CT/MRI models, (2) To develop a novel analytical tool to measure 3D dimensions of the neural foramen and canal and validate the accuracy of these measurements using human cadaver specimens, and (3) To integrate these new and other existing standalone analytical tools into one user-friendly software package, to be made freely available on the web to investigators of large, multi-site clinical imaging studies on spinal manipulative therapies and the research community overall. New analytical tools for facet kinematics using 3D CT/MRI models and facet-based coordinate systems will be developed. A new method for 3D foramen and spinal canal analysis will be developed using a CT/MR combined 3D model. State-of-the-art technologies, which have been developed for spine biomechanics, will also be adapted for clinical studies on spinal manipulation. The analyses will include: 3D spinal alignment, 3D kinematics of the spinal motion segment during flexion, extension, lateral bending and axial rotation. These analyses will be helpful to understand the relationship between spinal structure and function and changes in spinal structure and movement before and after spinal manipulation. The new techniques to be developed in the proposed project will be validated using cadaveric specimens, and data on the accuracy of individual techniques will be provided for rigorous studies on spinal manipulation. The baseline information will be used for power analyses to assess sample size for future study designs. The analytical methods to be developed and adapted for the studies on effects of spinal manipulation will be integrated in one software package so that even the investigators who are not familiar with mathematical analyses can use these analytical methods. The software package will be released to the public domain through a dedicated website. The outcomes from the proposed study are expected to be equally effective for evaluating other forms of complementary and alternative medicine (CAM) for other musculoskeletal disorders.