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Burton W, Crespo IR, Andreassen T, Pryhoda M, Jensen A, Myers C, Shelburne K, Banks S, Rullkoetter P. Fully automatic tracking of native glenohumeral kinematics from stereo-radiography. Comput Biol Med 2023; 163:107189. [PMID: 37393783 DOI: 10.1016/j.compbiomed.2023.107189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
The current work introduces a system for fully automatic tracking of native glenohumeral kinematics in stereo-radiography sequences. The proposed method first applies convolutional neural networks to obtain segmentation and semantic key point predictions in biplanar radiograph frames. Preliminary bone pose estimates are computed by solving a non-convex optimization problem with semidefinite relaxations to register digitized bone landmarks to semantic key points. Initial poses are then refined by registering computed tomography-based digitally reconstructed radiographs to captured scenes, which are masked by segmentation maps to isolate the shoulder joint. A particular neural net architecture which exploits subject-specific geometry is also introduced to improve segmentation predictions and increase robustness of subsequent pose estimates. The method is evaluated by comparing predicted glenohumeral kinematics to manually tracked values from 17 trials capturing 4 dynamic activities. Median orientation differences between predicted and ground truth poses were 1.7∘ and 8.6∘ for the scapula and humerus, respectively. Joint-level kinematics differences were less than 2∘ in 65%, 13%, and 63% of frames for XYZ orientation DoFs based on Euler angle decompositions. Automation of kinematic tracking can increase scalability of tracking workflows in research, clinical, or surgical applications.
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Affiliation(s)
- William Burton
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA.
| | - Ignacio Rivero Crespo
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
| | - Thor Andreassen
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
| | - Moira Pryhoda
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
| | - Andrew Jensen
- Department of Mechanical and Aerospace Engineering, University of Florida, 939 Center Dr., Gainesville, FL, 32611, USA
| | - Casey Myers
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
| | - Kevin Shelburne
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
| | - Scott Banks
- Department of Mechanical and Aerospace Engineering, University of Florida, 939 Center Dr., Gainesville, FL, 32611, USA
| | - Paul Rullkoetter
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO, 80210, USA
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Munsch MA, Como CJ, Gale TH, Fowler JR, Anderst WJ. Validation of Dynamic Biplane Radiography and Three-Dimensional Model-Based Tracking for Evaluation of Dynamic Thumb Kinematics. J Biomech 2022; 142:111236. [DOI: 10.1016/j.jbiomech.2022.111236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
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Akhbari B, Morton AM, Moore DC, Crisco JJ. Biplanar Videoradiography to Study the Wrist and Distal Radioulnar Joints. J Vis Exp 2021:10.3791/62102. [PMID: 33616093 PMCID: PMC8182367 DOI: 10.3791/62102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Accurate measurement of skeletal kinematics in vivo is essential for understanding normal joint function, the influence of pathology, disease progression, and the effects of treatments. Measurement systems that use skin surface markers to infer skeletal motion have provided important insight into normal and pathological kinematics, however, accurate arthrokinematics cannot be attained using these systems, especially during dynamic activities. In the past two decades, biplanar videoradiography (BVR) systems have enabled many researchers to directly study the skeletal kinematics of the joints during activities of daily living. To implement BVR systems for the distal upper extremity, videoradiographs of the distal radius and the hand are acquired from two calibrated X-ray sources while a subject performs a designated task. Three-dimensional (3D) rigid-body positions are computed from the videoradiographs via a best-fit registrations of 3D model projections onto to each BVR view. The 3D models are density-based image volumes of the specific bone derived from independently acquired computed-tomography data. Utilizing graphics processor units and high-performance computing systems, this model-based tracking approach is shown to be fast and accurate in evaluating the wrist and distal radioulnar joint biomechanics. In this study, we first summarized the previous studies that have established the submillimeter and subdegree agreement of BVR with an in vitro optical motion capture system in evaluating the wrist and distal radioulnar joint kinematics. Furthermore, we used BVR to compute the center of rotation behavior of the wrist joint, to evaluate the articulation pattern of the components of the implant upon one another, and to assess the dynamic change of ulnar variance during pronosupination of the forearm. In the future, carpal bones may be captured in greater detail with the addition of flat panel X-ray detectors, more X-ray sources (i.e., multiplanar videoradiography), or advanced computer vision algorithms.
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Affiliation(s)
| | - Amy M Morton
- Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Douglas C Moore
- Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Joseph J Crisco
- Center for Biomedical Engineering, Brown University; Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
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Validation and application of dynamic biplane radiography to study in vivo ankle joint kinematics during high-demand activities. J Biomech 2020; 103:109696. [PMID: 32139098 DOI: 10.1016/j.jbiomech.2020.109696] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 12/26/2022]
Abstract
Ankle ligament injuries are the most common musculoskeletal injury in physically active populations. Failure to restore native kinematics post-injury often leads to long-term consequences including chronic instability and arthritis. Using traditional motion capture, it is difficult to distinguish independent motions of the tibiotalar and subtalar joints to assess the effects of injury, surgical repair, and rehabilitation on ankle joint complex (AJC) kinematics. Therefore, the aims of this study were to determine the accuracy of dynamic biplane radiography for determining in vivo AJC kinematics and arthrokinematics, and to identify sport-related movements that require the largest AJC range of motion (ROM) during support. Two subjects had three to five 1.0 mm diameter tantalum beads implanted into the tibia, fibula, talus, and calcaneus during lateral ankle ligament repair. Six months after surgery, the subjects executed seven movements while biplane radiographs were collected. Bone motion was tracked using radiostereophotogrammetric analysis (RSA) as a "gold standard", and compared to a volumetric CT model-based tracking algorithm that matched digitally reconstructed radiographs to the original biplane radiographs. Over all movements, the average tibiotalar, subtalar and tibiofibular RMS errors were 0.5 mm ± 0.2 mm, 0.8 mm ± 0.5 mm and 0.8 mm ± 0.3 mm in translation and 1.4° ± 0.4°, 1.5° ± 0.5° and 1.7° ± 0.6° in rotation, respectively. Tibiotalar joint space was determined with an average precision of 0.5 mm. ROM results indicate that jumping and a forward-to-backward push-off movement are the best of the seven sport-related movements evaluated for eliciting full ROM kinematics.
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Kage CC, Akbari-Shandiz M, Foltz MH, Lawrence RL, Brandon TL, Helwig NE, Ellingson AM. Validation of an automated shape-matching algorithm for biplane radiographic spine osteokinematics and radiostereometric analysis error quantification. PLoS One 2020; 15:e0228594. [PMID: 32059007 PMCID: PMC7021291 DOI: 10.1371/journal.pone.0228594] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/18/2020] [Indexed: 11/19/2022] Open
Abstract
Biplane radiography and associated shape-matching provides non-invasive, dynamic, 3D osteo- and arthrokinematic analysis. Due to the complexity of data acquisition, each system should be validated for the anatomy of interest. The purpose of this study was to assess our system’s acquisition methods and validate a custom, automated 2D/3D shape-matching algorithm relative to radiostereometric analysis (RSA) for the cervical and lumbar spine. Additionally, two sources of RSA error were examined via a Monte Carlo simulation: 1) static bead centroid identification and 2) dynamic bead tracking error. Tantalum beads were implanted into a cadaver for RSA and cervical and lumbar spine flexion and lateral bending were passively simulated. A bead centroid identification reliability analysis was performed and a vertebral validation block was used to determine bead tracking accuracy. Our system’s overall root mean square error (RMSE) for the cervical spine ranged between 0.21–0.49mm and 0.42–1.80° and the lumbar spine ranged between 0.35–1.17mm and 0.49–1.06°. The RMSE associated with RSA ranged between 0.14–0.69mm and 0.96–2.33° for bead centroid identification and 0.25–1.19mm and 1.69–4.06° for dynamic bead tracking. The results of this study demonstrate our system’s ability to accurately quantify segmental spine motion. Additionally, RSA errors should be considered when interpreting biplane validation results.
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Affiliation(s)
- Craig C. Kage
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Mohsen Akbari-Shandiz
- Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Mary H. Foltz
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rebekah L. Lawrence
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Taycia L. Brandon
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Nathaniel E. Helwig
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States of America
- School of Statistics, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Arin M. Ellingson
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
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Akbari-Shandiz M, Lawrence RL, Ellingson AM, Johnson CP, Zhao KD, Ludewig PM. MRI vs CT-based 2D-3D auto-registration accuracy for quantifying shoulder motion using biplane video-radiography. J Biomech 2018; 82:375-380. [PMID: 30385001 DOI: 10.1016/j.jbiomech.2018.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
Biplane 2D-3D registration approaches have been used for measuring 3D, in vivo glenohumeral (GH) joint kinematics. Computed tomography (CT) has become the gold standard for reconstructing 3D bone models, as it provides high geometric accuracy and similar tissue contrast to video-radiography. Alternatively, magnetic resonance imaging (MRI) would not expose subjects to radiation and provides the ability to add cartilage and other soft tissues to the models. However, the accuracy of MRI-based 2D-3D registration for quantifying glenohumeral kinematics is unknown. We developed an automatic 2D-3D registration program that works with both CT- and MRI-based image volumes for quantifying joint motions. The purpose of this study was to use the proposed 2D-3D auto-registration algorithm to describe the humerus and scapula tracking accuracy of CT- and MRI-based registration relative to radiostereometric analysis (RSA) during dynamic biplanar video-radiography. The GH kinematic accuracy (RMS error) was 0.6-1.0 mm and 0.6-2.2° for the CT-based registration and 1.4-2.2 mm and 1.2-2.6° for MRI-based registration. Higher kinematic accuracy of CT-based registration was expected as MRI provides lower spatial resolution and bone contrast as compared to CT and suffers from spatial distortions. However, the MRI-based registration is within an acceptable accuracy for many clinical research questions.
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Affiliation(s)
- Mohsen Akbari-Shandiz
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA; Department of Rehabilitation Medicine, Divisions of Rehabilitation Science and Physical Therapy, Medical School, University of Minnesota, MN, USA
| | - Rebekah L Lawrence
- Department of Rehabilitation Medicine, Divisions of Rehabilitation Science and Physical Therapy, Medical School, University of Minnesota, MN, USA
| | - Arin M Ellingson
- Department of Rehabilitation Medicine, Divisions of Rehabilitation Science and Physical Therapy, Medical School, University of Minnesota, MN, USA
| | - Casey P Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kristin D Zhao
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Paula M Ludewig
- Department of Rehabilitation Medicine, Divisions of Rehabilitation Science and Physical Therapy, Medical School, University of Minnesota, MN, USA.
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An interpolation technique to enable accurate three-dimensional joint kinematic analyses using asynchronous biplane fluoroscopy. Med Eng Phys 2018; 60:109-116. [PMID: 30098937 DOI: 10.1016/j.medengphy.2018.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 05/25/2018] [Accepted: 07/22/2018] [Indexed: 11/22/2022]
Abstract
Biplane 2D-3D model-based registration and radiostereometric analysis (RSA) approaches have been commonly used for measuring three-dimensional, in vivo joint kinematics. However, in clinical biplane systems, the x-ray images are acquired asynchronously, which introduces registration errors. The present study introduces an interpolation technique to reduce image registration error by generating synchronous fluoroscopy image estimates. A phantom study and cadaveric shoulder study were used to evaluate the level of improvement in image registration that could be obtained as a result of using our interpolation technique. Our phantom study results show that the interpolated bead tracking technique was in better agreement with the true bead positions than when asynchronous images were used alone. The overall RMS error of glenohumeral kinematics for interpolated biplane registration was reduced by 1.27 mm, 0.40 mm, and 0.47 mm in anterior-posterior, superior-inferior, and medial-lateral translation, respectively; and 0.47°, 0.67°, and 0.19° in ab-adduction, internal-external rotation and flexion-extension, respectively, compared to asynchronous registration. The interpolated biplane registration results were consistent with previously reported studies using custom synchronous biplane fluoroscopy technology. This approach will be particularly useful for improving the kinematic accuracy of high velocity activities when using clinical biplane fluoroscopes or two independent c-arms, which are available at a number of institutions.
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In vivo validation of patellofemoral kinematics during overground gait and stair ascent. Gait Posture 2018; 64:191-197. [PMID: 29929162 PMCID: PMC6084796 DOI: 10.1016/j.gaitpost.2018.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The patellofemoral (PF) joint is a common site for non-specific anterior knee pain. The pathophysiology of patellofemoral pain may be related to abnormal motion of the patella relative to the femur, leading to increased stress at the patellofemoral joint. Patellofemoral motion cannot be accurately measured using conventional motion capture. RESEARCH QUESTION The aim of this study was to determine the accuracy of a biplane radiography system for measuring in vivo PF motion during walking and stair ascent. METHODS Four subjects had three 1.0 mm diameter tantalum beads implanted into the patella. Participants performed three trials each of over ground walking and stair ascent while biplane radiographs were collected at 100 Hz. Patella motion was tracked using radiostereophotogrammetric analysis (RSA) as a "gold standard", and compared to a volumetric CT model-based tracking algorithm that matched digitally reconstructed radiographs to the original biplane radiographs. RESULTS The average RMS difference between the RSA and model-based tracking was 0.41 mm and 1.97° when there was no obstruction from the contralateral leg. These differences increased by 34% and 40%, respectively, when the patella was at least partially obstructed by the contralateral leg. The average RMS difference in patellofemoral joint space between tracking methods was 0.9 mm or less. SIGNIFICANCE Previous validations of biplane radiographic systems have estimated tracking accuracy by moving cadaveric knees through simulated motions. These validations were unable to replicate in vivo kinematics, including patella motion due to muscle activation, and failed to assess the imaging and tracking challenges related to contralateral limb obstruction. By replicating the muscle contraction, movement velocity, joint range of motion, and obstruction of the patella by the contralateral limb, the present study provides a realistic estimate of patellofemoral tracking accuracy for future in vivo studies.
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Senteler M, Aiyangar A, Weisse B, Farshad M, Snedeker JG. Sensitivity of intervertebral joint forces to center of rotation location and trends along its migration path. J Biomech 2018; 70:140-148. [DOI: 10.1016/j.jbiomech.2017.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/04/2017] [Accepted: 10/27/2017] [Indexed: 12/13/2022]
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Eskandari A, Arjmand N, Shirazi-Adl A, Farahmand F. Subject-specific 2D/3D image registration and kinematics-driven musculoskeletal model of the spine. J Biomech 2017; 57:18-26. [DOI: 10.1016/j.jbiomech.2017.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/12/2017] [Accepted: 03/13/2017] [Indexed: 11/26/2022]
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Dynamic measurements of cervical neural foramina during neck movements in asymptomatic young volunteers. Surg Radiol Anat 2017; 39:1069-1078. [DOI: 10.1007/s00276-017-1847-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/09/2017] [Indexed: 10/19/2022]
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Aiyangar A, Zheng L, Anderst W, Zhang X. Instantaneous centers of rotation for lumbar segmental extension in vivo. J Biomech 2017; 52:113-121. [DOI: 10.1016/j.jbiomech.2016.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 12/14/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
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Mahato NK, Montuelle S, Goubeaux C, Cotton J, Williams S, Thomas J, Clark BC. Quantification of intervertebral displacement with a novel MRI-based modeling technique: Assessing measurement bias and reliability with a porcine spine model. Magn Reson Imaging 2016; 38:77-86. [PMID: 28027908 DOI: 10.1016/j.mri.2016.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to develop a novel magnetic resonance imaging (MRI)-based modeling technique for measuring intervertebral displacements. Here, we present the measurement bias and reliability of the developmental work using a porcine spine model. Porcine lumbar vertebral segments were fitted in a custom-built apparatus placed within an externally calibrated imaging volume of an open-MRI scanner. The apparatus allowed movement of the vertebrae through pre-assigned magnitudes of sagittal and coronal translation and rotation. The induced displacements were imaged with static (T1) and fast dynamic (2D HYCE S) pulse sequences. These images were imported into animation software, in which these images formed a background 'scene'. Three-dimensional models of vertebrae were created using static axial scans from the specimen and then transferred into the animation environment. In the animation environment, the user manually moved the models (rotoscoping) to perform model-to-'scene' matching to fit the models to their image silhouettes and assigned anatomical joint axes to the motion-segments. The animation protocol quantified the experimental translation and rotation displacements between the vertebral models. Accuracy of the technique was calculated as 'bias' using a linear mixed effects model, average percentage error and root mean square errors. Between-session reliability was examined by computing intra-class correlation coefficients (ICC) and the coefficient of variations (CV). For translation trials, a constant bias (β0) of 0.35 (±0.11) mm was detected for the 2D HYCE S sequence (p=0.01). The model did not demonstrate significant additional bias with each mm increase in experimental translation (β1Displacement=0.01mm; p=0.69). Using the T1 sequence for the same assessments did not significantly change the bias (p>0.05). ICC values for the T1 and 2D HYCE S pulse sequences were 0.98 and 0.97, respectively. For rotation trials, a constant bias (β0) of 0.62 (±0.12)° was detected for the 2D HYCE S sequence (p<0.01). The model also demonstrated an additional bias (β1Displacement) of 0.05° with each degree increase in the experimental rotation (p<0.01). Using T1 sequence for the same assessments did not significantly change the bias (p>0.05). ICC values for the T1 and 2D HYCE S pulse sequences were recorded 0.97 and 0.91, respectively. This novel quasi-static approach to quantifying intervertebral relationship demonstrates a reasonable degree of accuracy and reliability using the model-to-image matching technique with both static and dynamic sequences in a porcine model. Future work is required to explore multi-planar assessment of real-time spine motion and to examine the reliability of our approach in humans.
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Affiliation(s)
- Niladri K Mahato
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Biomedical Sciences, Ohio University, Athens, OH 45701, United States.
| | - Stephane Montuelle
- Department of Biomedical Sciences, Ohio University, Athens, OH 45701, United States.
| | - Craig Goubeaux
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Mechanical Engineering, Ohio University, Athens, OH 45701, United States.
| | - John Cotton
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Mechanical Engineering, Ohio University, Athens, OH 45701, United States.
| | - Susan Williams
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Biomedical Sciences, Ohio University, Athens, OH 45701, United States.
| | - James Thomas
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Biomedical Sciences, Ohio University, Athens, OH 45701, United States; School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH 45701, United States.
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States; Department of Biomedical Sciences, Ohio University, Athens, OH 45701, United States; Department of Geriatric Medicine, Ohio University, Athens, OH 45701, United States.
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Mahato NK, Montuelle S, Cotton J, Williams S, Thomas J, Clark B. Development of a morphology-based modeling technique for tracking solid-body displacements: examining the reliability of a potential MRI-only approach for joint kinematics assessment. BMC Med Imaging 2016; 16:38. [PMID: 27189195 PMCID: PMC4870733 DOI: 10.1186/s12880-016-0140-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/03/2016] [Indexed: 11/25/2022] Open
Abstract
Background Single or biplanar video radiography and Roentgen stereophotogrammetry (RSA) techniques used for the assessment of in-vivo joint kinematics involves application of ionizing radiation, which is a limitation for clinical research involving human subjects. To overcome this limitation, our long-term goal is to develop a magnetic resonance imaging (MRI)-only, three dimensional (3-D) modeling technique that permits dynamic imaging of joint motion in humans. Here, we present our initial findings, as well as reliability data, for an MRI-only protocol and modeling technique. Methods We developed a morphology-based motion-analysis technique that uses MRI of custom-built solid-body objects to animate and quantify experimental displacements between them. The technique involved four major steps. First, the imaging volume was calibrated using a custom-built grid. Second, 3-D models were segmented from axial scans of two custom-built solid-body cubes. Third, these cubes were positioned at pre-determined relative displacements (translation and rotation) in the magnetic resonance coil and scanned with a T1 and a fast contrast-enhanced pulse sequences. The digital imaging and communications in medicine (DICOM) images were then processed for animation. The fourth step involved importing these processed images into an animation software, where they were displayed as background scenes. In the same step, 3-D models of the cubes were imported into the animation software, where the user manipulated the models to match their outlines in the scene (rotoscoping) and registered the models into an anatomical joint system. Measurements of displacements obtained from two different rotoscoping sessions were tested for reliability using coefficient of variations (CV), intraclass correlation coefficients (ICC), Bland-Altman plots, and Limits of Agreement analyses. Results Between-session reliability was high for both the T1 and the contrast-enhanced sequences. Specifically, the average CVs for translation were 4.31 % and 5.26 % for the two pulse sequences, respectively, while the ICCs were 0.99 for both. For rotation measures, the CVs were 3.19 % and 2.44 % for the two pulse sequences with the ICCs being 0.98 and 0.97, respectively. A novel biplanar imaging approach also yielded high reliability with mean CVs of 2.66 % and 3.39 % for translation in the x- and z-planes, respectively, and ICCs of 0.97 in both planes. Conclusions This work provides basic proof-of-concept for a reliable marker-less non-ionizing-radiation-based quasi-dynamic motion quantification technique that can potentially be developed into a tool for real-time joint kinematics analysis.
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Affiliation(s)
- Niladri K Mahato
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA. .,Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, USA.
| | - Stephane Montuelle
- Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, USA
| | - John Cotton
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA.,Department of Mechanical Engineering, Ohio University, Athens, OH, 45701, USA
| | - Susan Williams
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA.,Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, USA
| | - James Thomas
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA.,School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH, 45701, USA
| | - Brian Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, 45701, USA.,Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, USA.,Department of Geriatric Medicine, Ohio University, Athens, OH, 45701, USA
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Apportionment of lumbar L2–S1 rotation across individual motion segments during a dynamic lifting task. J Biomech 2015; 48:3709-15. [DOI: 10.1016/j.jbiomech.2015.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/12/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
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16
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Do in vivo kinematic studies provide insight into adjacent segment degeneration? A qualitative systematic literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 24:1865-81. [DOI: 10.1007/s00586-015-3992-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 05/02/2015] [Accepted: 05/03/2015] [Indexed: 02/07/2023]
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Influence of implant rod curvature on sagittal correction of scoliosis deformity. Spine J 2014; 14:1432-9. [PMID: 24275616 DOI: 10.1016/j.spinee.2013.08.042] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 06/27/2013] [Accepted: 08/23/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Deformation of in vivo-implanted rods could alter the scoliosis sagittal correction. To our knowledge, no previous authors have investigated the influence of implanted-rod deformation on the sagittal deformity correction during scoliosis surgery. PURPOSE To analyze the changes of the implant rod's angle of curvature during surgery and establish its influence on sagittal correction of scoliosis deformity. STUDY DESIGN A retrospective analysis of the preoperative and postoperative implant rod geometry and angle of curvature was conducted. PATIENT SAMPLE Twenty adolescent idiopathic scoliosis patients underwent surgery. Average age at the time of operation was 14 years. OUTCOME MEASURES The preoperative and postoperative implant rod angle of curvature expressed in degrees was obtained for each patient. METHODS Two implant rods were attached to the concave and convex side of the spinal deformity. The preoperative implant rod geometry was measured before surgical implantation. The postoperative implant rod geometry after surgery was measured by computed tomography. The implant rod angle of curvature at the sagittal plane was obtained from the implant rod geometry. The angle of curvature between the implant rod extreme ends was measured before implantation and after surgery. The sagittal curvature between the corresponding spinal levels of healthy adolescents obtained by previous studies was compared with the implant rod angle of curvature to evaluate the sagittal curve correction. The difference between the postoperative implant rod angle of curvature and normal spine sagittal curvature of the corresponding instrumented level was used to evaluate over or under correction of the sagittal deformity. RESULTS The implant rods at the concave side of deformity of all patients were significantly deformed after surgery. The average degree of rod deformation Δθ at the concave and convex sides was 15.8° and 1.6°, respectively. The average preoperative and postoperative implant rod angle of curvature at the concave side was 33.6° and 17.8°, respectively. The average preoperative and postoperative implant rod angle of curvature at the convex side was 25.5° and 23.9°, respectively. A significant relationship was found between the degree of rod deformation and preoperative implant rod angle of curvature (r=0.60, p<.005). The implant rods at the convex side of all patients did not have significant deformation. The results indicate that the postoperative sagittal outcome could be predicted from the initial rod shape. CONCLUSIONS Changes in implant rod angle of curvature may lead to over- or undercorrection of the sagittal curve. Rod deformation at the concave side suggests that corrective forces acting on that side are greater than the convex side.
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Aiyangar AK, Zheng L, Tashman S, Anderst WJ, Zhang X. Capturing Three-Dimensional In Vivo Lumbar Intervertebral Joint Kinematics Using Dynamic Stereo-X-Ray Imaging. J Biomech Eng 2013; 136:011004. [DOI: 10.1115/1.4025793] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Indexed: 11/08/2022]
Abstract
Availability of accurate three-dimensional (3D) kinematics of lumbar vertebrae is necessary to understand normal and pathological biomechanics of the lumbar spine. Due to the technical challenges of imaging the lumbar spine motion in vivo, it has been difficult to obtain comprehensive, 3D lumbar kinematics during dynamic functional tasks. The present study demonstrates a recently developed technique to acquire true 3D lumbar vertebral kinematics, in vivo, during a functional load-lifting task. The technique uses a high-speed dynamic stereo-radiography (DSX) system coupled with a volumetric model-based bone tracking procedure. Eight asymptomatic male participants performed weight-lifting tasks, while dynamic X-ray images of their lumbar spines were acquired at 30 fps. A custom-designed radiation attenuator reduced the radiation white-out effect and enhanced the image quality. High resolution CT scans of participants' lumbar spines were obtained to create 3D bone models, which were used to track the X-ray images via a volumetric bone tracking procedure. Continuous 3D intervertebral kinematics from the second lumbar vertebra (L2) to the sacrum (S1) were derived. Results revealed motions occurring simultaneously in all the segments. Differences in contributions to overall lumbar motion from individual segments, particularly L2–L3, L3–L4, and L4–L5, were not statistically significant. However, a reduced contribution from the L5–S1 segment was observed. Segmental extension was nominally linear in the middle range (20%–80%) of motion during the lifting task, but exhibited nonlinear behavior at the beginning and end of the motion. L5–S1 extension exhibited the greatest nonlinearity and variability across participants. Substantial AP translations occurred in all segments (5.0 ± 0.3 mm) and exhibited more scatter and deviation from a nominally linear path compared to segmental extension. Maximum out-of-plane rotations (<1.91 deg) and translations (<0.94 mm) were small compared to the dominant motion in the sagittal plane. The demonstrated success in capturing continuous 3D in vivo lumbar intervertebral kinematics during functional tasks affords the possibility to create a baseline data set for evaluating the lumbar spinal function. The technique can be used to address the gaps in knowledge of lumbar kinematics, to improve the accuracy of the kinematic input into biomechanical models, and to support development of new disk replacement designs more closely replicating the natural lumbar biomechanics.
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Affiliation(s)
- Ameet K. Aiyangar
- EMPA (Swiss Federal Laboratories for Materials Science and Research), Mechanical Systems Engineering (Lab 304), Ueberlandstrasse 129, Duebendorf 8400, Switzerland
- Department of Orthopaedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Liying Zheng
- Department of Orthopaedic Surgery, Musculoskeletal Modeling Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Scott Tashman
- Department of Orthopaedic Surgery, Department of Bioengineering, Orthopaedic Biodynamics Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - William J. Anderst
- Department of Orthopaedic Surgery, Orthopaedic Biodynamics Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Xudong Zhang
- Department of Orthopaedic Surgery, Department of Bioengineering, Department of Mechanical Engineering and Materials Science, Musculoskeletal Modeling Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
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Iatridis JC, Nicoll SB, Michalek AJ, Walter BA, Gupta MS. Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair? Spine J 2013; 13:243-62. [PMID: 23369494 PMCID: PMC3612376 DOI: 10.1016/j.spinee.2012.12.002] [Citation(s) in RCA: 219] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 07/26/2012] [Accepted: 12/09/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Degeneration and injuries of the intervertebral disc (IVD) result in large alterations in biomechanical behaviors. Repair strategies using biomaterials can be optimized based on the biomechanical and biological requirements of the IVD. PURPOSE To review the present literature on the effects of degeneration, simulated degeneration, and injury on biomechanics of the IVD, with special attention paid to needle puncture injuries, which are a pathway for diagnostics and regenerative therapies and the promising biomaterials for disc repair with a focus on how those biomaterials may promote biomechanical repair. STUDY DESIGN A narrative review to evaluate the role of biomechanics on disc degeneration and regenerative therapies with a focus on what biomechanical properties need to be repaired and how to evaluate and accomplish such repairs using biomaterials. Model systems for the screening of such repair strategies are also briefly described. METHODS Articles were selected from two main PubMed searches using keywords: intervertebral AND biomechanics (1,823 articles) and intervertebral AND biomaterials (361 articles). Additional keywords (injury, needle puncture, nucleus pressurization, biomaterials, hydrogel, sealant, tissue engineering) were used to narrow the articles down to the topics most relevant to this review. RESULTS Degeneration and acute disc injuries have the capacity to influence nucleus pulposus (NP) pressurization and annulus fibrosus (AF) integrity, which are necessary for an effective disc function and, therefore, require repair. Needle injection injuries are of particular clinical relevance with the potential to influence disc biomechanics, cellularity, and metabolism, yet these effects are localized or small and more research is required to evaluate and reduce the potential clinical morbidity using such techniques. NP replacement strategies, such as hydrogels, are required to restore the NP pressurization or the lost volume. AF repair strategies including cross-linked hydrogels, fibrous composites, and sealants offer promise for regenerative therapies to restore AF integrity. Tissue engineered IVD structures, as a single implantable construct, may promote greater tissue integration due to the improved repair capacity of the vertebral bone. CONCLUSIONS IVD height, neutral zone characteristics, and torsional biomechanics are sensitive to specific alterations in the NP pressurization and AF integrity and must be addressed for an effective functional repair. Synthetic and natural biomaterials offer promise for NP replacement, AF repair, as an AF sealant, or whole disc replacement. Meeting mechanical and biological compatibilities are necessary for the efficacy and longevity of the repair.
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Affiliation(s)
- James C. Iatridis
- Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY
| | - Steven B. Nicoll
- Department of Biomedical Engineering, The City College of New York, New York, NY
| | - Arthur J. Michalek
- Department of Molecular Physiology and Biophysics, University of Vermont, Burlington, VT
| | - Benjamin A. Walter
- Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY,Department of Biomedical Engineering, The City College of New York, New York, NY
| | - Michelle S. Gupta
- Department of Biomedical Engineering, The City College of New York, New York, NY
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Miranda DL, Schwartz JB, Loomis AC, Brainerd EL, Fleming BC, Crisco JJ. Static and dynamic error of a biplanar videoradiography system using marker-based and markerless tracking techniques. J Biomech Eng 2012; 133:121002. [PMID: 22206419 DOI: 10.1115/1.4005471] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The use of biplanar videoradiography technology has become increasingly popular for evaluating joint function in vivo. Two fundamentally different methods are currently employed to reconstruct 3D bone motions captured using this technology. Marker-based tracking requires at least three radio-opaque markers to be implanted in the bone of interest. Markerless tracking makes use of algorithms designed to match 3D bone shapes to biplanar videoradiography data. In order to reliably quantify in vivo bone motion, the systematic error of these tracking techniques should be evaluated. Herein, we present new markerless tracking software that makes use of modern GPU technology, describe a versatile method for quantifying the systematic error of a biplanar videoradiography motion capture system using independent gold standard instrumentation, and evaluate the systematic error of the W.M. Keck XROMM Facility's biplanar videoradiography system using both marker-based and markerless tracking algorithms under static and dynamic motion conditions. A polycarbonate flag embedded with 12 radio-opaque markers was used to evaluate the systematic error of the marker-based tracking algorithm. Three human cadaveric bones (distal femur, distal radius, and distal ulna) were used to evaluate the systematic error of the markerless tracking algorithm. The systematic error was evaluated by comparing motions to independent gold standard instrumentation. Static motions were compared to high accuracy linear and rotary stages while dynamic motions were compared to a high accuracy angular displacement transducer. Marker-based tracking was shown to effectively track motion to within 0.1 mm and 0.1 deg under static and dynamic conditions. Furthermore, the presented results indicate that markerless tracking can be used to effectively track rapid bone motions to within 0.15 deg for the distal aspects of the femur, radius, and ulna. Both marker-based and markerless tracking techniques were in excellent agreement with the gold standard instrumentation for both static and dynamic testing protocols. Future research will employ these techniques to quantify in vivo joint motion for high-speed upper and lower extremity impacts such as jumping, landing, and hammering.
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Affiliation(s)
- Daniel L Miranda
- Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School, Brown University, Providence, RI 02912, USA.
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21
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Weisse B, Aiyangar AK, Affolter C, Gander R, Terrasi GP, Ploeg H. Determination of the translational and rotational stiffnesses of an L4-L5 functional spinal unit using a specimen-specific finite element model. J Mech Behav Biomed Mater 2012; 13:45-61. [PMID: 22842275 DOI: 10.1016/j.jmbbm.2012.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 03/30/2012] [Accepted: 04/02/2012] [Indexed: 11/25/2022]
Abstract
The knowledge of spinal kinematics is of paramount importance for many aspects of clinical application (i.e. diagnosis, treatment and surgical intervention) and for the development of new spinal implants. The aim of this study was to determine the translational and rotational stiffnesses of a functional spinal unit (FSU) L4-L5 using a specimen-specific finite element model. The results are needed as input data for three-dimensional (3D) multi-body musculoskeletal models in order to simulate vertebral motions and loading in the lumbar spine during daily activities. Within the modelling process, a technique to partition the constitutive members and to calibrate their mechanical properties for the complex model is presented. The material and geometrical non-linearities originating from the disc, the ligaments and the load transfer through the zygapophysial joints were considered. The FSU was subjected to pure moments and forces in the three anatomical planes. For each of the loading scenarios, with and without vertical and follower preload, the presented technique provides results in fair agreement with the literature. The novel representation of the nonlinear behaviour of the translational and rotational stiffness of the disc as a function of the displacement can be used directly as input data for multi-body models.
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Affiliation(s)
- B Weisse
- Laboratory for Mechanical Systems Engineering, Empa Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland.
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22
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Boustani HN, Rohlmann A, van der Put R, Burger A, Zander T. Which postures are most suitable in assessing spinal fusion using radiostereometric analysis? Clin Biomech (Bristol, Avon) 2012; 27:111-6. [PMID: 21924805 DOI: 10.1016/j.clinbiomech.2011.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 08/22/2011] [Accepted: 08/23/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Up to now, plain radiographs are not well suited to assess spinal fusion. Radiostereometric analysis performed for two postures may deliver more reliable results. However, it is unknown, which postures are most suitable for this procedure. METHODS In a finite element study, spinal fusion at the level L4-5 was simulated assuming a posterior approach and the implantation of two cages and a spinal fixation device. The change of the distance between markers in vertebrae adjacent to the cages was calculated for moving from one of the following postures standing, flexion, extension, axial rotation, lying, and extension in a lying position to another. The changes of marker distances were calculated for the intact model, as well as for the situations: directly after surgery before fusion started, in the early-fusion-phase and in the late-fusion-phase. Differences in the marker motion between two postoperative situations were also calculated. FINDINGS The most anteriorly placed markers showed the greatest motion between two postures. The greatest differences in marker motions between the two situations before-fusion and early-fusion-phase (0.54 mm) as well as between early-fusion-phase and late-fusion-phase (0.34 mm) were found for the two postures flexion while standing and extension in a lying position. INTERPRETATION Pairs of X-rays taken while standing with maximum flexed upper body and while lying with maximum extended trunk are most suited for the assessment of spinal fusion when using radiostereometric analysis.
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Affiliation(s)
- Hadi N Boustani
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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23
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Zhu Z, Massimini DF, Wang G, Warner JJP, Li G. The accuracy and repeatability of an automatic 2D-3D fluoroscopic image-model registration technique for determining shoulder joint kinematics. Med Eng Phys 2012; 34:1303-9. [PMID: 22285714 DOI: 10.1016/j.medengphy.2011.12.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/05/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
Abstract
Fluoroscopic imaging, using single plane or dual plane images, has grown in popularity to measure dynamic in vivo human shoulder joint kinematics. However, no study has quantified the difference in spatial positional accuracy between single and dual plane image-model registration applied to the shoulder joint. In this paper, an automatic 2D-3D image-model registration technique was validated for accuracy and repeatability with single and dual plane fluoroscopic images. Accuracy was assessed in a cadaver model, kinematics found using the automatic registration technique were compared to those found using radiostereometric analysis. The in vivo repeatability of the automatic registration technique was assessed during the dynamic abduction motion of four human subjects. The in vitro data indicated that the error in spatial positional accuracy of the humerus and the scapula was less than 0.30mm in translation and less than 0.58° in rotation using dual plane images. Single plane accuracy was satisfactory for in-plane motion variables, but out-of-plane motion variables on average were approximately 8 times less accurate. The in vivo test indicated that the repeatability of the automatic 2D-3D image-model registration was 0.50mm in translation and 1.04° in rotation using dual images. For a single plane technique, the repeatability was 3.31mm in translation and 2.46° in rotation for measuring shoulder joint kinematics. The data demonstrate that accurate and repeatable shoulder joint kinematics can be obtained using dual plane fluoroscopic images with an automatic 2D-3D image-model registration technique; and that out-of-plane motion variables are less accurate than in-plane motion variables using a single plane technique.
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Affiliation(s)
- Zhonglin Zhu
- Department of Biomedical Engineering, Tsinghua University, Beijing, China.
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Cerciello T, Romano M, Bifulco P, Cesarelli M, Allen R. Advanced template matching method for estimation of intervertebral kinematics of lumbar spine. Med Eng Phys 2011; 33:1293-302. [DOI: 10.1016/j.medengphy.2011.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 06/15/2011] [Accepted: 06/18/2011] [Indexed: 10/18/2022]
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Passias PG, Wang S, Kozanek M, Xia Q, Li W, Grottkau B, Wood KB, Li G. Segmental lumbar rotation in patients with discogenic low back pain during functional weight-bearing activities. J Bone Joint Surg Am 2011; 93:29-37. [PMID: 21209266 PMCID: PMC3004094 DOI: 10.2106/jbjs.i.01348] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Little information is available on vertebral motion in patients with discogenic low back pain under physiological conditions. We previously validated a combined dual fluoroscopic and magnetic resonance imaging system to investigate in vivo lumbar kinematics. The purpose of the present study was to characterize mechanical dysfunction among patients with confirmed discogenic low back pain, relative to asymptomatic controls without degenerative disc disease, by quantifying abnormal vertebral motion. METHODS Ten subjects were recruited for the present study. All patients had discogenic low back pain confirmed clinically and radiographically at L4-L5 and L5-S1. Motions were reproduced with use of the combined imaging technique during flexion-extension, left-to-right bending, and left-to-right twisting movements. From local coordinate systems at the end plates, relative motions of the cephalad vertebrae with respect to caudad vertebrae were calculated at each of the segments from L2 to S1. Range of motion of the primary rotations and coupled translations and rotations were determined. RESULTS During all three movements, the greatest range of motion was observed at L3-L4. L3-L4 had significantly greater motion than L2-L3 with left-right bending and left-right twisting movements (p < 0.05). The least motion occurred at L5-S1 for all movements; the motion at this level was significantly smaller than that at L3-L4 (p < 0.05). Range of motion during left-right bending and left-right twisting at L3-L4 was significantly larger in the degenerative disc disease group than in the normal group. The range of motion at L4-L5 was significantly larger in the degenerative group than in the normal group during flexion; however, the ranges of motion in both groups were similar during left-to-right bending and left-to-right twisting. CONCLUSIONS The greatest range of motion in patients with discogenic back pain was observed at L3-L4; this motion was greater than that in normal subjects, suggesting that superior adjacent levels developed segmental hypermobility prior to undergoing fusion. L5-S1 had the least motion, suggesting that segmental hypomobility ensues at this level in patients with discogenic low back pain.
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Affiliation(s)
- Peter G. Passias
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Shaobai Wang
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Michal Kozanek
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Qun Xia
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Weishi Li
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Brian Grottkau
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Kirkham B. Wood
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
| | - Guoan Li
- Bioengineering Laboratory, Department of Orthopaedic
Surgery, Massachusetts General Hospital, 1215 GRJ, 55 Fruit Street, Boston, MA
02114. E-mail address for P.G. Passias:
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Martin DE, Greco NJ, Klatt BA, Wright VJ, Anderst WJ, Tashman S. Model-based tracking of the hip: implications for novel analyses of hip pathology. J Arthroplasty 2011; 26:88-97. [PMID: 20347253 DOI: 10.1016/j.arth.2009.12.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Accepted: 12/03/2009] [Indexed: 02/01/2023] Open
Abstract
This study investigated the efficacy of a combined high-speed, biplane radiography and model-based tracking technique to study hip joint kinematics and arthrokinematics. Comparing model-based tracking to the gold standard of radiostereometric analysis using implanted metal beads, joint translation was measured with a bias of 0.2 mm and a precision of 0.3 mm, whereas joint rotation was measured with a bias of 0.2° and a precision of 0.8°. A novel measure of hip arthrokinematics characterizing the region of closest contact in the anterosuperior acetabulum was measured with a bias of 0.9% and a precision of 2.5%. Model-based tracking of the hip thus provides the opportunity to noninvasively study hip pathologic conditions such as osteoarthritis and femoroacetabular impingement with great accuracy.
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Affiliation(s)
- Daniel E Martin
- University of Pittsburgh Medical Center Department of Orthopedic Surgery, Pittsburgh, Pennsylvania, USA
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McDonald CP, Bachison CC, Chang V, Bartol SW, Bey MJ. Three-dimensional dynamic in vivo motion of the cervical spine: assessment of measurement accuracy and preliminary findings. Spine J 2010; 10:497-504. [PMID: 20359957 DOI: 10.1016/j.spinee.2010.02.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 01/18/2010] [Accepted: 02/18/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous research has quantified cervical spine motion with conventional measurement techniques (eg, cadaveric studies, motion capture systems, and fluoroscopy), but these techniques were not designed to accurately measure three-dimensional (3D) dynamic cervical spine motion under in vivo conditions. PURPOSE The purposes of this study were to characterize the accuracy of model-based tracking for measuring 3D dynamic cervical spine kinematics and to demonstrate its in vivo application. STUDY DESIGN Through accuracy assessment and application of technique, in vivo cervical spine motion was measured. METHODS The accuracy of model-based tracking for measuring cervical spine motion was determined in an in vitro experiment. Tantalum beads were implanted into the vertebrae of an ovine specimen, and biplane X-ray images were acquired as the specimen's neck was manually moved through neck extension and axial neck rotation. The 3D position and orientation of each cervical vertebra were determined from the biplane X-ray images using model-based tracking. For comparison, the position and orientation of each vertebra were also determined by tracking the position of the implanted beads with dynamic radiostereometric analysis. To demonstrate in vivo application of this technique, biplane X-ray images were acquired as a human subject performed two motion tasks: neck extension and axial neck rotation. The positions and orientations of each cervical vertebra were determined with model-based tracking. Cervical spine motion was reported with standard kinematic descriptions of translation and rotation. RESULTS The in vitro validation demonstrated that model-based tracking is accurate to within +/-0.6 mm and +/-0.6 degrees for measuring cervical spine motion. For the in vivo application, there were significant rotations about all three anatomical axes for both the neck extension and axial neck rotation motion tasks. CONCLUSIONS Model-based tracking is an accurate technique for measuring in vivo, 3D, dynamic cervical spine motion. Preliminary data acquired using this technique are in agreement with previous studies. It is anticipated that this experimental approach will enhance our understanding of cervical spine motion under normal and pathologic conditions.
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Affiliation(s)
- Colin P McDonald
- Bone and Joint Center, Henry Ford Hospital, Detroit, MI 48202, USA.
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