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Prediction and measurement of intervertebral movements of the lumbar spine.

机译:腰椎椎间运动的预测和测量。

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摘要

Measurement of intervertebral movements is essential in the clinical diagnosis and assessment of low back pain and spinal disorders such as instability. It is possible to measure gross movements of the entire lumbar spine using markers or sensors attached to the skin. But such techniques are not accurate enough to provide information about intervertebral movement as the magnitude of the movement is similar to that of the error due to soft tissue deformation underlying the sensors. Radiographic methods are able to provide accurate data, but this involves identification and superimposition of vertebral images which is a time consuming and technically demanding process. This thesis attempted to address the above limitations by two related studies. The purpose of the first study was to examine the feasibility of an inverse kinematic algorithm in predicting intervertebral movements using information derived from skin-mounted sensors. The second study involved the development of an automatic method of identifying vertebral images in radiographs and computing their movements. This would significantly reduce data processing time and increase the attraction of the radiographic method as a clinical tool for measuring intervertebral movements.; In the first study, an inverse kinematic model was employed to determine the optimum intervertebral joint configuration for a given forward-bending posture of the human spine. An optimization equation with physiological constraints was employed to determine the intervertebral joint configuration. Experimental validation was performed using lateral radiographs of the lumbosacral spines of twenty-two subjects (9 men and 13 women, 40 +/- 14 years old). The model was found to be valid for predicting the intervertebral rotations of the lumbar spine segments but not intervertebral translations. The differences between the measured and predicted values of intervertebral rotations were generally small (less than 1.6 degrees). Pearson product-moment correlations were found to be high, ranging from 0.83 to 0.97, for prediction of intervertebral rotation, but poor for intervertebral translation (R = 0.08 to 0.67). The inverse kinematic model can be clinically useful for predicting intervertebral rotation when X-ray or invasive measurements are undesirable. It is also useful in biomechanical modeling, which requires accurate kinematic information as model input data.; Knowledge of the intervertebral translations of the spine is essential in the clinical assessment of some clinical disorders such as instability, spondylolysis or spondylolisthesis. Unfortunately, such assessment could not reliably performed using the inverse kinematic method but only by radiographic measurement. In the second part of this study, the precision and accuracy of a new automatic method to determine intervertebral movements were examined. Active contour was employed for segmentation of vertebral body image, providing a rapid and accurate measurement of vertebral shape using Fourier descriptors. A Genetic Algorithm was then utilized to determine the displacements of the vertebral bodies. Lateral radiographs of the lumbosacral spines of twenty-two healthy male volunteers (21 +/- 1 years old) were taken in full flexion and extension. The vertebral body image was fitted with a quadrangle and its corners to be digitised. This allowed the intervertebral movement to be determined manually. The mean differences in the angles determined by the manual and automatic method were less than 1.4 degrees; whereas the mean differences in posterior-anterior and superior-inferior translations less than 1.2 mm and 0.8 mm respectively. The correlation of vertebral body outline as determined by the automatic method in the flexion and extension films was high, with R values ranging from 0.994 to 0.997. This indicates that no image distortion or out-of-plane movements occur. The root mean square error of data among five repeated measurements were less than
机译:椎间运动的测量对于临床诊断和评估下背痛和脊柱疾病(例如不稳定)至关重要。使用附着在皮肤上的标记或传感器可以测量整个腰椎的总体运动。但是这样的技术不够准确,无法提供有关椎间运动的信息,因为运动的幅度类似于由于传感器下面的软组织变形而引起的误差。射线照相方法能够提供准确的数据,但这涉及椎骨图像的识别和叠加,这是一个耗时且技术要求高的过程。本文试图通过两项相关研究来解决上述局限性。第一项研究的目的是检验使用从皮肤传感器安装的信息预测运动学反演算法在椎间运动预测中的可行性。第二项研究涉及一种自动方法,该方法可以识别射线照片中的椎骨图像并计算其运动。这将显着减少数据处理时间,并增加放射线照相法作为测量椎间运动的临床工具的吸引力。在第一个研究中,采用反向运动学模型来确定对于给定的人体脊柱前屈姿势的最佳椎间关节构形。具有生理约束的优化方程被用来确定椎间关节的形态。实验验证是通过对22名受试者(9名男性和13名女性,40 +/- 14岁)的腰spin部脊柱进行侧位X线照片进行的。发现该模型可有效预测腰椎节段的椎间旋转,但不能预测椎间平移。椎间旋转的测量值与预测值之间的差异通常很小(小于1.6度)。发现皮尔逊乘积矩相关性在预测椎间旋转方面具有很高的相关性,范围从0.83至0.97,而对于椎间平移则较差(R = 0.08至0.67)。当不希望使用X射线或侵入性测量时,逆运动学模型在临床上可用于预测椎间旋转。在生物力学建模中也很有用,它需要精确的运动学信息作为模型输入数据。在一些临床疾病(例如不稳定,脊椎松解或脊椎滑脱)的临床评估中,了解脊柱的椎骨间平移至关重要。不幸的是,使用逆运动学方法不能可靠地进行这样的评估,而只能通过射线照相测量来进行。在本研究的第二部分中,研究了一种确定椎间运动的自动方法的准确性和准确性。主动轮廓线用于椎体图像的分割,使用傅立叶描述符快速准确地测量椎骨形状。然后利用遗传算法确定椎体的位移。完全屈曲和伸展时,对22名健康的男性志愿者(21 +/- 1岁)的腰ac部脊柱进行了侧位X线照相。椎体图像上有一个四边形,其四角被数字化。这样可以手动确定椎间运动。通过手动和自动方法确定的角度的平均差异小于1.4度;而前后前后平移的平均差分别小于1.2 mm和0.8 mm。通过自动方法确定的屈曲和伸展膜中椎体轮廓的相关性很高,R值介于0.994至0.997之间。这表明没有图像失真或平面外移动发生。五次重复测量中数据的均方根误差小于

著录项

  • 作者

    Sun, Loi Wah.;

  • 作者单位

    Hong Kong Polytechnic University (Hong Kong).;

  • 授予单位 Hong Kong Polytechnic University (Hong Kong).;
  • 学科 Health Sciences Rehabilitation and Therapy.
  • 学位 Ph.D.
  • 年度 2006
  • 页码 242 p.
  • 总页数 242
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 康复医学;
  • 关键词

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