Articulated Model Registration of MRI/X-Ray Spine Data

Collection : Lecture Notes in Computer Science ; vol. 6112This paper presents a method based on articulated models for the registration of spine data extracted from multimodal medical images of patients with scoliosis. With the ultimate aim being the development of a complete geometrical model of the torso of a scoliotic patient, this work presents a method for the registration of vertebral column data using 3D magnetic resonance images (MRI) acquired in prone position and X-ray data acquired in standing position for five patients with scoliosis. The 3D shape of the vertebrae is estimated from both image modalities for each patient, and an articulated model is used in order to calculate intervertebral transformations required in order to align the vertebrae between both postures. Euclidean distances between anatomical landmarks are calculated in order to assess multimodal registration error. Results show a decrease in the Euclidean distance using the proposed method compared to rigid registration and more physically realistic vertebrae deformations compared to thin-plate-spline (TPS) registration thus improving alignment.IRS

Методические разработки для подготовки к практическим занятиям по оториноларингологии студентов 4-го курса стоматологического факультета ВГМУ

ГОРЛА БОЛЕЗНИНОСА БОЛЕЗНИОТОРИНОЛАРИНГОЛОГИЯУХА БОЛЕЗНИУЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯВ методических разработках подробно изложены методики исследования ЛОР-органов, вопросы по анатомо-топографическим особенностям и физиологии уха, носа, глотки и гортани; представлены вопросы, касающиеся знаний и умений студентов по оториноларингологии, современные методы диагностики и лечения наиболее распространенных заболеваний ЛОР-органов; даны варианты тестов для определения уровня знаний, вопросы для самоподготовки к практическим занятиям

Increased rod stiffness improves the degree of deformity correction by segmental pedicle screw fixation in adolescent idiopathic scoliosis

<p>Abstract</p> <p>Background</p> <p>There are limited reports in literature studying the impact of rod diameter and stiffness on the degree of deformity correction in patients with AIS.</p> <p>Aims</p> <p>The aims of this study were to evaluate the 3-dimentional deformity correction achieved by segmental pedicle screw fixation in patients with adolescent idiopathic scoliosis, and to find out if learning or the change to stiffer rods had any positive impact on deformity correction.</p> <p>Study design</p> <p>Retrospective study.</p> <p>Methods</p> <p>Plain radiographs and low-dose spine CTs of 116 consecutive patients (aged 15.9 ± 2.8 years) operated during the period 2005-2009 (group 1: patients operated autumn 2005-2006; group 2: 2007; group 3: 2008; group 4: 2009) were retrospectively evaluated.</p> <p>Results</p> <p>There was no statistically significant difference between the correction of the Cobb angle (P = 0.425) or lower end vertebra tilt (P = 0.298) in patients operated during the first versus the remaining periods of the study. No restoration of the sagittal kyphosis was reported in the first period compared with 5.9° in the last study period (P < 0.001). The correction of vertebral rotation was also improved from 4.2° to 7.8° (P < 0.001) for the same periods. For the whole study population, there was statistically significant correlation between the order of the operation (patient number) and the restoration of sagittal kyphosis (r = -0.344, P = 0.001), and the correction of vertebral rotation (r = 0.370, P < 0.001), but not for the Cobb angle or LEVT. However, there was no significant difference in restoration of sagittal kyphosis and the vertebral rotation in the first 17 patients compared with the last 17 patients operated with rods of 5.5 mm diameter (P = 0.621, and 0.941, respectively), indicating that rod stiffness had more impact on the deformity correction than did learning.</p> <p>Conclusions</p> <p>This study showed that rod stiffness had more impact on the deformity correction than did learning.</p

Temporary use of shape memory spinal rod in the treatment of scoliosis

NiTinol shape memory alloy is characterized by its malleability at low temperatures and its ability to return to a preconfigured shape above its activation temperature. This process can be utilized to assist in scoliosis correction. The goal of this retrospective study was to evaluate the clinical and radiographic results of intraoperative use of shape memory alloy rod in the correction of scoliosis. From May 2002 to September 2006, 38 scoliosis patients (ranging from 50° to 120°; 22 cases over 70°) who underwent shape memory alloy-assisted correction in our institute were reviewed. During the operation, a shape memory alloy rod served as a temporary correction tool. Following correction, the rod was replaced by a rigid rod. The mean blood loss at surgery was 680 ± 584 ml; the mean operative time was 278 ± 62 min. The major Cobb angle improved from an average 78.4° preoperatively to 24.3° postoperatively (total percent correction 71.4%). In 16 patients with a major curve <70° and flexibility of 52.7%, the deformity improved from 58.4° preoperatively to 12.3° postoperatively (percent correction, 78.9%). In 22 patients with a major curve >70° and flexibility of 25.6%, the deformity improved from 94.1° preoperatively to 30.1° postoperatively (percent correction, 68.1%). Only one case had a deep infection. There were no neurologic, vascular or correction-related complications such as screw pullout or metal fracture. The study shows that the intraoperative use of a shape memory rod is a safe and effective method to correct scoliosis

Juvenile idiopathic scoliosis treated with posterior arthrodesis and segmental pedicle screw instrumentation before the age of 9 years: a 5-year follow-up

<p>Abstract</p> <p>Study design</p> <p>Retrospective study.</p> <p>Objective</p> <p>To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up.</p> <p>Summary of background data</p> <p>Progression of spinal deformity after posterior instrumentation and fusion in immature patients has been reported by several authors. Segmental pedicle screw fixation has been shown to be effective in controlling both coronal and sagittal plane deformities. However, there is no long term study of fusion with segmental pedicle screw fixation in these group of patients.</p> <p>Methods</p> <p>Seven patients with juvenile idiopathic scoliosis treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 7.4 years (range 5–9 years) at the time of the operation. All the patients were followed up 5 years or more (range 5–8 years) and were all Risser V at the most recent follow up. Three dimensional reconstruction of the radiographs was obtained and 3DStudio Max software was used for combining, evaluating and modifying the technical data derived from both 2d and 3d scan data.</p> <p>Results</p> <p>The preoperative thoracic curve of 56 ± 15° was corrected to 24 ± 17° (57% correction) at the latest follow-up. The lumbar curve of 43 ± 14° was corrected to 23 ± 6° (46% correction) at the latest follow-up. The preoperative thoracic kyphosis of 37 ± 13° and the lumbar lordosis of 33 ± 13° were changed to 27 ± 13° and 42 ± 21°, respectively at the latest follow-up. None of the patients showed coronal decompensation at the latest follow-up. Four patients had no evidence of crankshaft phenomenon. In two patients slight increase in Cobb angle at the instrumented segments with a significant increase in AVR suggesting crankshaft phenomenon was seen. One patient had a curve increase in both instrumented and non instrumented segments due to incorrect strategy.</p> <p>Conclusion</p> <p>In juvenile idiopathic curves of Risser 0 patients with open triradiate cartilages, routine combined anterior fusion to prevent crankshaft may not be warranted by posterior segmental pedicle screw instrumentation.</p

Impact of brain overgrowth on sensorial learning processing during the first year of life

Macrocephaly is present in about 2–5% of the general population. It can be found as an isolated benign trait or as part of a syndromic condition. Brain overgrowth has been associated with neurodevelopmental disorders such as autism during the first year of life, however, evidence remains inconclusive. Furthermore, most of the studies have involved pathological or high-risk populations, but little is known about the effects of brain overgrowth on neurodevelopment in otherwise neurotypical infants. We investigated the impact of brain overgrowth on basic perceptual learning processes (repetition effects and change detection response) during the first year of life. We recorded high density electroencephalograms (EEG) in 116 full-term healthy infants aged between 3 and 11 months, 35 macrocephalic (14 girls) and 81 normocephalic (39 girls) classified according to the WHO head circumference norms. We used an adapted oddball paradigm, time-frequency analyses, and auditory event-related brain potentials (ERPs) to investigate differences between groups. We show that brain overgrowth has a significant impact on repetition effects and change detection response in the 10–20 Hz frequency band, and in N450 latency, suggesting that these correlates of sensorial learning processes are sensitive to brain overgrowth during the first year of life

Biomechanical evaluation of predictive parameters of progression in adolescent isthmic spondylolisthesis: a computer modeling and simulation study

<p>Abstract</p> <p>Background</p> <p>Pelvic incidence, sacral slope and slip percentage have been shown to be important predicting factors for assessing the risk of progression of low- and high-grade spondylolisthesis. Biomechanical factors, which affect the stress distribution and the mechanisms involved in the vertebral slippage, may also influence the risk of progression, but they are still not well known. The objective was to biomechanically evaluate how geometric sacral parameters influence shear and normal stress at the lumbosacral junction in spondylolisthesis.</p> <p>Methods</p> <p>A finite element model of a low-grade L5-S1 spondylolisthesis was constructed, including the morphology of the spine, pelvis and rib cage based on measurements from biplanar radiographs of a patient. Variations provided on this model aimed to study the effects on low grade spondylolisthesis as well as reproduce high grade spondylolisthesis. Normal and shear stresses at the lumbosacral junction were analyzed under various pelvic incidences, sacral slopes and slip percentages. Their influence on progression risk was statistically analyzed using a one-way analysis of variance.</p> <p>Results</p> <p>Stresses were mainly concentrated on the growth plate of S1, on the intervertebral disc of L5-S1, and ahead the sacral dome for low grade spondylolisthesis. For high grade spondylolisthesis, more important compression and shear stresses were seen in the anterior part of the growth plate and disc as compared to the lateral and posterior areas. Stress magnitudes over this area increased with slip percentage, sacral slope and pelvic incidence. Strong correlations were found between pelvic incidence and the resulting compression and shear stresses in the growth plate and intervertebral disc at the L5-S1 junction.</p> <p>Conclusions</p> <p>Progression of the slippage is mostly affected by a movement and an increase of stresses at the lumbosacral junction in accordance with spino-pelvic parameters. The statistical results provide evidence that pelvic incidence is a predictive parameter to determine progression in isthmic spondylolisthesis.</p