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1.
Ann Biomed Eng ; 50(4): 401-412, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35201548

RESUMO

A recent innovation in scoliosis monitoring is the use of ultrasonography, which provides true 3D information in one scan and does not emit ionizing radiation. Measuring the severity of scoliosis on ultrasonographs requires identifying lamina pairs on the most tilted vertebrae, which is difficult and time-consuming. To expedite and automate measurement steps, this paper detailed an automatic convolutional neural network-based algorithm for identifying the laminae on 3D ultrasonographs. The predicted laminae were manually paired to measure the lateral spinal curvature on the coronal view, called the Cobb angle. In total, 130 spinal ultrasonographs of adolescents with idiopathic scoliosis recruited from a scoliosis clinic were selected, with 70 for training and 60 for testing. Data augmentation increased the effective training set size to 140 ultrasonographs. Semi-automatic Cobb measurements were compared to manual measurements on the same ultrasonographs. The semi-automatic measurements demonstrated good inter-method reliability (ICC3,1 = 0.87) and performed better on thoracic (ICC3,1 = 0.91) than lumbar curves (ICC3,1 = 0.81). The mean absolute difference and standard deviation between semi-automatic and manual was 3.6° ± 3.0°. In conclusion, the semi-automatic method to measure the Cobb angle on ultrasonographs is feasible and accurate. This is the first algorithm that automates steps of Cobb angle measurement on ultrasonographs.


Assuntos
Escoliose , Coluna Vertebral , Adolescente , Humanos , Redes Neurais de Computação , Reprodutibilidade dos Testes , Escoliose/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Ultrassonografia/métodos
2.
No Shinkei Geka ; 50(5): 1044-1052, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36128820

RESUMO

Surgical site infection(SSI)is among the most serious complications of spinal surgery in terms of patient health status and clinical outcomes. The use of prophylactic antimicrobials does not eliminate SSIs. Risk factors for SSI exist during not only the intraoperative period, but also all perioperative periods. In addition to intraoperative surgical risk factors, patient-related factors such as age, nutritional status, diabetes, smoking, obesity, coexistent infections in a remote part of the body, and colonization with microorganisms have also been reported. Therefore, it is important to reduce the risk of SSIs even before surgery, which requires knowledge about SSIs and prevention efforts. Spinal surgery can cause deep SSIs, instrumented infections, and meningitis resulting from cerebrospinal fluid infection. Spinal SSIs can be predicted by detecting changes in wound sites, pain and fever, and trends in hematological examination. However, special attention should be given to instrumented surgeries because of the subclinical nature of bacterial biofilm formation on the surface of implants. Therefore, it is important to aim for early detection and treatment of SSIs while reducing perioperative risks to decrease the potential for poor outcomes due to spinal SSIs.


Assuntos
Coluna Vertebral , Infecção da Ferida Cirúrgica , Humanos , Procedimentos Neurocirúrgicos/efeitos adversos , Fatores de Risco , Medula Espinal , Coluna Vertebral/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/cirurgia
4.
Semin Musculoskelet Radiol ; 26(4): 387-395, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103882

RESUMO

The incidence of spondylodiskitis has increased over the last 20 years worldwide, especially in the immunodepressed population, and it remains a complex pathology, both in terms of diagnosis and treatment. Because clinical symptoms are often nonspecific and blood culture negative, imaging plays an essential role in the diagnostic process. Magnetic resonance imaging, in particular, is the gold standard technique because it can show essential findings such as vertebral bone marrow, disk signal alteration, a paravertebral or epidural abscess, and, in the advanced stage of disease, fusion or collapse of the vertebral elements. However, many noninfectious spine diseases can simulate spinal infection. In this article, we present imaging features of specific infectious spine diseases that help radiologists make the distinction between infectious and noninfectious processes.


Assuntos
Doenças da Coluna Vertebral , Medula Óssea , Humanos , Imageamento por Ressonância Magnética/métodos , Radiologistas , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/patologia , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/patologia
5.
Semin Musculoskelet Radiol ; 26(4): 439-452, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103886

RESUMO

Back pain is one of the leading causes of health costs worldwide, particularly because of the further increased aging population. After clinical examination, spinal imaging is of utmost importance in many patients to reach the correct diagnosis. There are many imaging pitfalls and mimickers of spinal pathology on radiographs, magnetic resonance imaging, and computed tomography. These mimickers may lead to a misdiagnosis or a further imaging work-up if they are not recognized and thus lead to unnecessary examinations and increased health care costs. In this review we present the common mimickers of spinal pathology and describe normal variations when reading imaging studies of the spine.


Assuntos
Imageamento por Ressonância Magnética , Coluna Vertebral , Idoso , Erros de Diagnóstico , Humanos , Imageamento por Ressonância Magnética/métodos , Radiografia , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
6.
Semin Musculoskelet Radiol ; 26(4): 478-490, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103889

RESUMO

Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and the most commonly found in the spine, with a high impact on health care systems and on morbidity due to vertebral fractures (VFs).This article discusses state-of-the-art techniques on the imaging of metabolic bone diseases in the spine, from the well-established methods to the latest improvements, recent developments, and future perspectives.We review the classical features of involvement of metabolic conditions involving the spine. Then we analyze the different imaging techniques for the diagnosis, characterization, and monitoring of metabolic bone disease: dual-energy X-ray absorptiometry (DXA) and DXA-based fracture risk assessment applications or indexes, such as the geometric parameters, Bone Strain Index, and Trabecular Bone Score; quantitative computed tomography; and magnetic resonance and ultrasonography-based techniques, such as radiofrequency echographic multi spectrometry. We also describe the current possibilities of imaging to guide the treatment of VFs secondary to metabolic bone disease.


Assuntos
Osteoporose , Fraturas da Coluna Vertebral , Absorciometria de Fóton/métodos , Densidade Óssea , Humanos , Osteoporose/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem
7.
Semin Musculoskelet Radiol ; 26(4): 491-500, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103890

RESUMO

Metabolic bone diseases comprise a wide spectrum. Osteoporosis, the most frequent, characteristically involves the spine, with a high impact on health care systems and on the morbidity of patients due to the occurrence of vertebral fractures (VFs).Part II of this review completes an overview of state-of-the-art techniques on the imaging of metabolic bone diseases of the spine, focusing on specific populations and future perspectives. We address the relevance of diagnosis and current status on VF assessment and quantification. We also analyze the diagnostic techniques in the pediatric population and then review the assessment of body composition around the spine and its potential application. We conclude with a discussion of the future of osteoporosis screening, through opportunistic diagnosis and the application of artificial intelligence.


Assuntos
Osteoporose , Fraturas da Coluna Vertebral , Inteligência Artificial , Criança , Diagnóstico por Imagem , Humanos , Osteoporose/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem
8.
Semin Musculoskelet Radiol ; 26(4): 501-509, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103891

RESUMO

Adolescent idiopathic scoliosis (AIS) is the most characteristic disorder of the adolescent spine. It is a three-dimensional (3D) disorder that occurs from 10 years of age and comprises 90% of all idiopathic scolioses. Imaging plays a central role in the diagnosis and follow-up of patients with AIS. Modern imaging offers 3D assessment of scoliosis with less radiation exposure. Imaging helps rule out occult conditions that cause spinal deformity. Various imaging methods are also used to assess skeletal maturity in patients with AIS, thus determining the growth spurt and risk of progression of scoliosis. This article provides a brief overview of the pathophysiology, biomechanics, clinical features, and modern imaging of AIS relevant to radiologists in clinical settings.


Assuntos
Escoliose , Adolescente , Fenômenos Biomecânicos , Humanos , Imageamento Tridimensional/métodos , Escoliose/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem
9.
Semin Musculoskelet Radiol ; 26(4): 510-520, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36103892

RESUMO

Spinal cord evaluation is an integral part of spine assessment, and its reliable imaging work-up is mandatory because even localized lesions may produce serious effects with potentially irreversible sequelae. Spinal cord alterations are found both incidentally during spine evaluation in otherwise neurologically asymptomatic patients or during neurologic/neuroradiologic assessment in myelopathic patients. Myelopathy (an umbrella term for any neurologic deficit that refers to spinal cord impairment) can be caused by intrinsic lesions or extrinsic mechanical compression, and its etiology may be both traumatic and/or nontraumatic. The symptoms largely depend on the size/extension of lesions, ranging from incontinence to ataxia, from spasticity to hyperreflexia, from numbness to weakness. Magnetic resonance imaging is the reference imaging modality in spinal cord evaluation, ensuring the best signal and spatial resolution. We provide an overview of the most common spinal cord disorders encountered by radiologists and describe the technical measures that offer optimal spinal cord visualization.


Assuntos
Compressão da Medula Espinal , Doenças da Medula Espinal , Humanos , Imageamento por Ressonância Magnética , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/etiologia , Doenças da Medula Espinal/complicações , Doenças da Medula Espinal/diagnóstico por imagem , Coluna Vertebral
10.
BMC Musculoskelet Disord ; 23(1): 847, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36068555

RESUMO

BACKGROUND: This study aimed to investigate the laterality of the pedicle morphology at the apical vertebra (AV) level and identify the radiographic factors associated with the laterality ratio of the pedicle morphology at the AV level in patients with adolescent idiopathic scoliosis (AIS). METHODS: Overall, 684 pedicles in 57 AIS patients aged 10-20 years, who underwent preoperative computed tomography (CT) and had Lenke type 1 or 2 with right convex main thoracic curves (MTC), were evaluated. Pedicle diameters of the MTC were assessed. We defined and compared the region containing two vertebrae adjacent to the AV (APEX±1) and the region containing two vertebrae adjacent to the neutral vertebra. We analyzed the pedicle diameter and laterality ratio of APEX±1 and performed multiple linear regression analysis to identify the radiographic factors associated with the laterality of the pedicle diameter. RESULTS: On the concave side of APEX±1, the pedicles of 15 patients (26.3%) did not accept a 4-mm-diameter pedicle screw (PS), even with 25% cortical bone width expansion. Laterality ratio differences in the pedicle diameters of the cortical bone width in APEX±1 were large in patients with more proximal AV level (p < 0.001) and smaller apical vertebral rotation (AVR) (p = 0.029). CONCLUSIONS: Preoperative planning to accurately select and insert the PS in AIS should be based on the anatomical limitations in APEX±1, AV level, and AVR degree. In APEX±1, the correlation between AVR and the laterality ratio of the pedicle diameter may be useful for pathoetiological interpretation of the AIS deformity.


Assuntos
Cifose , Parafusos Pediculares , Escoliose , Fusão Vertebral , Adolescente , Humanos , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Escoliose/cirurgia , Fusão Vertebral/métodos , Coluna Vertebral , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X/métodos
11.
Med Eng Phys ; 107: 103848, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36068030

RESUMO

Adolescent idiopathic scoliosis is a 3D lateral spinal curvature coupled with axial vertebral rotation (AVR). Measuring AVR during clinic is important because it affects treatment options and predicts the risk of scoliosis progression. However, manual measurements are time consuming and have high inter-rater and intra-rater errors. This study aimed to develop a machine learning algorithm based on convolutional neural networks (CNNs) to automatically calculate AVR on posteroanterior radiographs using three different segmentations including spinal column, individual vertebra, and pedicles. Separate labeling and training processes were performed on each of the developed segmentation algorithms. The final machine learning software was tested on 221 vertebrae from 17 spinal radiographs. An experienced rater with over 25 years of experience measured the 221 vertebral rotations manually. By comparing the manual and the fully automatic measurements, 81% (178/221) of the automatic measurements were within the clinical acceptance error (±5°). The mean absolute difference and the standard deviation between the manual and automatic measurements was 4.3° ± 5.7°. Based on the Bland-Altman plot, the manual and automatic measurements had a strong correlation and no bias. The error did not relate to the severity of the rotation. This method is fully automatic, and the result is comparable to others.


Assuntos
Escoliose , Adolescente , Algoritmos , Humanos , Aprendizado de Máquina , Radiografia , Escoliose/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas
12.
Curr Oncol ; 29(9): 6236-6244, 2022 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-36135059

RESUMO

(1) Background: Plasma cell neoplasia can be separated into independent subtypes including multiple myeloma (MM) and solitary plasmacytoma of the bone (SBP). The first clinical signs patients present with are skeletal pain, most commonly involving ribs and vertebrae. (2) Methods: Retrospective analysis of 114 patients (38 female, 76 male) receiving spinal surgery from March 2006 until April 2020. Neurological impairments and surgical instability were the criteria for intervention in this cohort. Analysis was based on demographic data, Spinal Instability Neoplastic Score (SINS), location of the lesion, spinal levels of tumor involvement, surgical treatment, histopathological workup, adjuvant therapy, functional outcome, and overall survival (OS). (3) Results: The following surgical procedures were performed: posterior stabilization only in 9 patients, posterior stabilization and decompression without vertebral body replacement in 56 patients, tumor debulking and decompression only in 8 patients, anterior approach in combined approach without vertebral body replacement and without biopsy and/or without kyphoplasty in 33 patients, 3 patients received biopsies only, and 5 patients received kyphoplasty only. The histopathology diagnoses were MM in 94 cases and SBP in 20 cases. Median OS was 72 months (53.4-90.6 months). Preoperative KPSS was 80% (range 40-100%), the postoperative KPSS was 80% (range 50-100%). (4) Conclusions: Surgery for patients with plasma cell neoplasia is beneficial in case of neurological impairment and spinal instability. Moreover, we were able to show that patients with MM and a low number of spinal levels to be supplied have a better prognosis as well as a younger age at the time of the surgical intervention.


Assuntos
Mieloma Múltiplo , Plasmocitoma , Neoplasias da Coluna Vertebral , Feminino , Humanos , Masculino , Mieloma Múltiplo/patologia , Plasmócitos/patologia , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/patologia , Coluna Vertebral/cirurgia , Resultado do Tratamento
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3313-3317, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086162

RESUMO

Loosening of pedicle screws after spinal fusion surgery can prevent the desired fusion between vertebrae and may be a reason for revision surgery. Especially in osteoporotic bone, toggling of pedicle screws is a common problem that compromises the fixation strength of these screws and can lead to loosening or axial pull-out of the screw. In this study, we explore the use of an in-pedicle expandable anchor that shapes to the pedicle to increase the toggling resistance of the anchor by increasing the contact area between the anchor and the dense cortical bone of the pedicle. A scaled-up, two-dimensional prototype was designed. The prototype consists of a bolt and ten stainless steel wedges that expand by tensioning the bolt. During the expansion, the wedges are required to compress the cancellous bone. Based on the first preliminary experiment, it was found that the expansion of the wedges resulted in successful compression of 5 PCF cancellous bone phantom (Sawbones). This preliminary study shows that an expandable in-pedicle anchor could be a feasible option to increase the toggling resistance of spinal bone anchors, especially in osteoporotic bone. Clinical Relevance- Toggling of pedicle screws is a major cause of screw loosening. In this preliminary study, the use of an in-pedicle expandable anchor to increase the toggling resistance of spinal bone anchors is explored.


Assuntos
Osteoporose , Parafusos Pediculares , Humanos , Osteoporose/cirurgia , Reoperação , Coluna Vertebral/cirurgia
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2149-2152, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086387

RESUMO

Maximum intensity projection (MIP) is a standard volume-rendering technique for 3D volumetric data processing. For example, given a 3D CT data, it simply projects the voxel values with its maximum intensity on a specific view to output a 2D image. Recently, MIP is further combined with Btrfly Net for vertebrae labelling task. However, this simple reformations of 3D data leads to loss of rich context information in volumetric data. In this paper, we propose a learned orthographic pooling approach instead of image processing based MIP. Typically, a simple conv-simple and bottleneck pooling modules are introduced to learn the orthographic projection of 3D data and output 2D intermediate feature maps. To this end, the learned orthographic pooling helps preserve detail information of 3D context during projection. Furthermore, an unified Btrfly Net is provided for vertebrae labelling by integrating the orthographic pooling sub-network. The novel Btrfly Net with orthographic pooling sub-network is evaluated on the 2014 MICCAI vertebra localization challenge dataset. Compared to original Butfly Net with MIP, orthographic pooling, the learned MIP largely boosts the performance of vertebrae labelling.


Assuntos
Processamento de Imagem Assistida por Computador , Coluna Vertebral , Processamento de Imagem Assistida por Computador/métodos , Coluna Vertebral/diagnóstico por imagem
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2136-2139, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086540

RESUMO

Multi-class segmentation of vertebrae and inter-vertebral discs (IVDs) is crucial for the diagnosis and treatment of spinal diseases. However, it is still a challenge due to similarities between neighboring vertebrae of a subject and differences among the IVDs from different subjects. In this paper, we propose a novel spine segmentation framework to achieve automatic segmentation of vertebrae and IVDs in MR images. The core component of the new framework is a Multi-View GCN (MVGCN), which utilizes multi-view features and graph convolutional network (GCN) to reason about the relations of vertebrae and IVDs. We additionally use a boundary constraint for better segmentation of the boundary between vertebrae and IVDs. We test our method on a public spine dataset of 172 MR volumetric images for the vertebrae and IVDs segmentation. The experimental results demonstrate the efficacy of our method. Code and models of our method will be available in the future.


Assuntos
Algoritmos , Coluna Vertebral , Humanos , Coluna Vertebral/diagnóstico por imagem
16.
Zootaxa ; 5165(1): 133-143, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-36095476

RESUMO

Ariosoma bengalense sp. nov. is described on the basis of two specimens having total length (TL) 216304 mm, collected from the northern part of the Bay of Bengal, India. The new species is characterized by the dorsal-fin origin positioned above the gill-opening margin and above the 9th lateral-line pores, supratemporal pore absent, 910 predorsal vertebrae; 4649 preanal vertebrae and 146149 total vertebrae. The new species most closely resembles the Indian species Ariosoma gnanadossi, the new species differs from A. gnanadossi having the snout length (SL) longer than eye diameter (snout length 1.42.0 in eye diameter) vs. snout length almost equal to the eye diameter in A. gnanadossi. Further, the new species has translucent pectoral fins vs. black pectoral fins in Ariosoma gnanadossi. The new species differs from four of the seven species reported from India: Ariosoma majus, A. melanospilos, A. maurostigma and A. indicum with absence of supratemporal pores vs. three in all the species mentioned.


Assuntos
Baías , Enguias , Animais , Brânquias , Índia , Coluna Vertebral
17.
JBJS Case Connect ; 12(3)2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-36099358

RESUMO

CASE: A 45-year-old woman had a grade II chondrosarcoma (T2N0M0G2) located at the spinous processes and laminas of T3-6 with the tumor extension into the spinal canal at T3-4. To perform en bloc tumor resection, we released or disarticulated bilateral costovertebral ligaments from T3-6 and cut the bilateral pedicles at T3-5 all from posteriorly. Then, we completed en bloc resection without violating the tumor capsule. CONCLUSION: Our novel procedure, bilateral osteotomy of pedicles for en bloc resection successfully allowed for en bloc tumor resection involving the posterior elements with wide surgical margins.


Assuntos
Condrossarcoma , Neoplasias da Coluna Vertebral , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Osteotomia/métodos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/cirurgia , Corpo Vertebral
18.
Zootaxa ; 5138(2): 137-151, 2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-36101031

RESUMO

Luciogobius punctilineatus n. sp. is described on the basis of 21 type specimens from Kyushu, and the Koshiki and Osumi Islands, southern Japan. It is also found in Kochi Prefecture (Shikoku) and Amami-oshima island (Ryukyu Islands), Japan, confirmed by examination of non-type specimens. The genus Luciogobius includes 15 valid and several undescribed species, and most of them inhabit interstitial spaces of stones and gravel in the intertidal zone. The new species is characterized by the following combination of characters: total second dorsal-fin rays 1012 (modally 11); total anal-fin rays 1214 (13); pectoral-fin rays 812 (10); vertebrae 1618 + 2224 = 3942 (17 + 23 = 40); pectoral-fin posterior margin slightly concave; pelvic fins united, forming a ventral disc; snout relatively short, length 3.14.3% of SL; anus to anal-fin origin (AAA) distance twice body depth at anus, 11.416.9% of SL; snout length less than 34.7% of AAA distance; pre-anus length less than 85.5% of pre-anal-fin length; single poorly defined black longitudinal line along mid-lateral body region from behind pectoral fin to caudal-fin base, indistinct anteriorly (line embedded, visible through semi-transparent muscle tissue in fresh or live specimens); black spots forming a single longitudinal row on mid-lateral body surface from behind pectoral fin to caudal-fin base (more distinct in preserved specimens).


Assuntos
Oligoquetos , Perciformes , Animais , Japão , Coluna Vertebral
19.
Biomed Res Int ; 2022: 8419739, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36072476

RESUMO

Endoscopic spine surgery (ESS) advances the principles of minimally invasive surgery, including minor collateral tissue damage, reduced blood loss, and faster recovery times. ESS allows for direct access to the spine through small incisions and direct visualization of spinal pathology via an endoscope. While this technique has many applications, there is a steep learning curve when adopting ESS into a surgeon's practice. Two types of navigation, optical and electromagnetic, may allow for widespread utilization of ESS by engendering improved orientation to surgical anatomy and reduced complication rates. The present review discusses these two available navigation technologies and their application in endoscopic procedures by providing case examples. Furthermore, we report on the future directions of navigation within the discipline of ESS.


Assuntos
Endoscopia , Coluna Vertebral , Endoscópios , Endoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos , Coluna Vertebral/cirurgia
20.
PLoS One ; 17(9): e0272529, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36084092

RESUMO

Pathologies such as cancer metastasis and osteoporosis strongly affect the mechanical properties of the vertebral bone and increase the risk of fragility fractures. The prediction of the fracture risk with a patient-specific model, directly generated from the diagnostic images of the patient, could help the clinician in the choice of the correct therapy to follow. But before such models can be used to support any clinical decision, their credibility must be demonstrated through verification, validation, and uncertainty quantification. In this study we describe a procedure for the generation of such patient-specific finite element models and present a first validation of the kinematics of the spine segment. Quantitative computed tomography images of a cadaveric lumbar spine segment presenting vertebral metastatic lesions were used to generate the model. The applied boundary conditions replicated a specific experimental test where the spine segment was loaded in compression-flexion. Model predictions in terms of vertebral surface displacements were compared against the full-field experimental displacements measured with Digital Image Correlation. A good agreement was obtained from the local comparison between experimental data and simulation results (R2 > 0.9 and RMSE% <8%). In conclusion, this work demonstrates the possibility to apply the developed modelling pipeline to predict the displacement field of human spine segment under physiological loading conditions, which is a first fundamental step in the credibility assessment of these clinical decision-support technology.


Assuntos
Vértebras Lombares , Coluna Vertebral , Fenômenos Biomecânicos , Simulação por Computador , Análise de Elementos Finitos , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiologia , Região Lombossacral , Coluna Vertebral/fisiologia
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