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: 8732001
• 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/8732001
• 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：这项研究的长期目标是设计一种非侵入性方法，以准确评估3-D 体内脊柱运动学促进旨在改善诊断和评估的临床研究 对于退化性脊柱条件。 假设：我们的中心假设是，可以开发出一种患者特异性的基于MRI的技术 准确量化连续的3-D椎骨运动，刻面关节运动以及脊柱和孔。 狭窄利用临床医生可以容易获得的工具，并且没有过多的辐射暴露。 以上假设是基于我们在实验室中的先前工作，这导致了 针对重建手术的人尸体研究的样品特异性，3-D运动评估工具。 具体目的：（1）非侵入性，双平面荧光成像的开发和离体验证 椎骨解剖结构的注册技术。工作假设1：双平面荧光镜登记 可以设计方法，结合3-D MRI解剖模型，可以准确评估节段 在离散位置的运动学与利用放射线球的实验室技术一样准确 植入每个椎骨。 （2）用于预测算法的开发和离体验证 从离散姿势测得的节段动作的连续运动数据。工作假设2： 使用3D样条函数插值可以创建基于连续运动数据的准确预测 在获得离散位置的双平面荧光镜数据上。 研究计划：我们将使用有关人尸体刺，CT和MRI-的实验研究的组合 基于解剖模型和双平面荧光影像学以开发一种非侵入性方法来获取 拟议研究的目的中指定的连续3-D运动数据。我们的整体方法是 在流程图中说明。研究的第一步是：（1）设计/完善用于注册的算法 使用双平面荧光影像学成像椎骨解剖结构； （2）设计/完善插值算法 从离散位置获取的椎骨运动数据中预测连续数据。这些算法将是 根据人尸体脊柱标本收集的实验数据实施。尸体实验 将同时产生：（i）使用radiopaque获得的“金标准”连续运动数据 植入椎体的球和由红外光组成的光电跟踪系统 每个椎骨和IRED跟踪摄像机附加的发射二极管，以及（ii）源自该的运动学数据 提出的双平面注册技术与插值算法结合使用以得出连续的 数据。我们将使用上面收集的实验数据来构建和比较3个样品特异性模型：（1）A 基于CT的黄金标准模型，（2）使用双平面荧光镜图像登记和（3）的基于CT的模型 使用双平面荧光镜图像登记的基于MRI的模型。根据计算的运动学参数 3-D数据将产生有关所提出的非侵入技术准确性和精度的信息。 意义：拟议的研究的贡献将包括：（1）强大的，无创的运动学 利用临床医生很容易获得的工具的评估程序； （2）一种非侵入性方法 获取连续的3-D运动数据，而不会过多辐射；与患者的结合 3-D解剖模型将允许动态评估旋转轴，刻面关节运动，脊柱管和 在功能负载方案下，有孔狭窄和体内3-D椎间盘变形。