Toward Patient Specific Technologies for Injury Prevention: Mapping The Effects of Pre-existing Conditions on Neurospine Injury Risk

患者特异性技术有可能彻底改变损伤预防和医疗，但受限于我们目前无法量化个体组织特征以及缺乏关于年龄、性别、身体形态（如体重指数）和预先存在的疾病（如骨质疏松症或椎管狭窄）对脊柱损伤风险的累积影响的信息。拟议研究计划的长期目标是利用技术进步和脊髓损伤阈值的最新研究结果，开发必要的技术，以实施针对患者的方法来预防、诊断和治疗脊柱和脊髓损伤。然而，在我们能够在临床上实施患者特定的方法之前，还有一些技术问题需要解决。本提案有三个目标，解决其中一些技术问题。首先，我们将定义神经组织对负载的材料响应的数学表达式，因为这些表达式影响我们的患者特定模型的准确性。其次，我们将确定这些模型对脊髓和脊柱大小和形状变化的敏感性（这些变化会随着年龄和疾病（如退行性椎间盘疾病）而变化）。最后，为了使这种方法在临床上可行，我们将开发在短时间内自动完成模型构建、执行和分析的方法。这项工作是新颖的，在其应用的患者特定的方法来了解脊柱和脊髓负荷所造成的外部影响。患者特异性技术的好处是，它们可以更有效地使用现有的诊断工具和程序，而额外成本有限。预计这些技术将通过限制治疗并发症来降低医疗保健成本，并通过更好地为个人定制治疗和预防策略来改善患者结局。

Patient specific technologies have the potential to revolutionize both injury prevention and medical treatment but are limited by our current inability to quantify individual tissue characteristics as well as a lack of information regarding the cumulative effects of aging, gender, body morphology (such as body mass index) and pre-existing conditions (such as osteoporosis or spinal stenosis) on spinal injury risk. The long term objective of the proposed research program is to leverage advances in technology and recent findings on spinal cord damage thresholds to develop the technologies necessary for implementing patient specific approaches into the prevention, diagnosis and treatment of spine and spinal cord injuries. However, before we can implement patient specific approaches in the clinic, there are a number of technical issues that need to be resolved. There are three objectives for this proposal that address some of these technical issues. First, we will define mathematical expressions for the material response of neurological tissues to loading as these expressions affect the accuracy of our patient specific models. Second, we will determine the sensitivity of these models to variations in spinal cord and column size and shape (which change with aging and diseases such as degenerative disc disease). And finally, for this approach to be clinically feasible, we will develop methods for the model construction, execution and analysis to be done automatically and within a short period of time. This work is novel in its application of patient-specific approaches for understanding spine and spinal cord loading resulting from an external impact. The benefit of patient-specific technologies is that they use existing diagnostic tools and procedures more effectively, with limited additional costs. It is expected that these technologies will reduce health care costs by limiting treatment complications and improve patient outcomes by better tailoring treatments and prevention strategies to individuals.