Ferguson
Fakultäten » Medizinische Fakultät » Rheumaklinik und Institut für physikalische Medizin » PD Dr. Anne Mannion » Ferguson
Completed research project
| Title / Titel | In Vivo Spinal Motion Analysis for Effective Patient Screening, Diagnosis and Follow-Up in the Treatment of Back Pain |
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| Abstract (PDF, 14 KB) | |||||||
| Original title / Originaltitel | In vivo Analyse der Wirbelsäulenbewegung für effektive Vorsorgeuntersuchungen, effektive Diagnosen und Nachfolgeuntersuchungen bei der Behandlung lumbaler Rückenschmerzen | ||||||
| Summary / Zusammenfassung | Background Back pain is one of the most expensive health care issues facing western society. There is evidence for a mechanical origin to back pain; i.e. back pain patients exhibit abnormal spinal motion. However, the anatomical basis of this abnormal motion or spinal “instability” is not clear, and effective methods of identifying at-risk patients and choosing appropriate treatment strategies must be further developed. Diagnostic methods based on the measurement of three-dimensional spinal kinematics have been proposed, but to date no non-invasive methods suitable for use in a broad patient population have been developed. Aims The objectives of this project are: (1) to develop and validate an accurate, non-invasive, in vivo method based on video fluoroscopy toof measure measuring dynamic three-dimensional spinal motion, based on video fluoroscopy, (2) to elucidate the relationship between degeneration/injury of individual anatomical structures of the spine and possible pain mechanisms related to spinal hypermobility, (3) to apply the video fluoroscopy method in the identification of specific pathological motion patterns associated with pain in back-pain patients and (4) to initiate the use of this method in clinical studies. Methods Non-invasive in vivo measurements of spinal motion will be based on analysis of dynamic video fluoroscopy image sequences taken during prescribed motion trials. Methods will be developed for the extraction of vertebral outlines from fluoroscopy images and subsequent pattern matching to projected outlines derived from a three-dimensional CT or ISO-C dataset of the spine. This largely automated process will provide a dynamic, fully three-dimensional description of spinal motion (inter-vertebral rotations plus translations), which to date has not been possible without surgical intervention. The accuracy of the image-based kinematic analysis will be evaluated in cadaver experiments by comparing simultaneous motion measurements obtained from the fluoroscopy technique with conventional optoelectronic motion analysis. In vitro validation studies will be followed by in vivo validation experiments on large breed dogs, using similar simultaneous motion measurement during passive and active motion exercises. The anatomical basis of abnormal spinal motion will be evaluated via laboratory studies of cadaver spine kinematics, comparing motion patterns of the intact specimen to those measured following sequential injury to individual spinal structures. Robust motion waveform processing, statistical and neural-network methods will be implemented for the analysis and comparison of motion patterns from multiple subjects. Expected Benefits With a non-invasive method, large patient populations can be evaluated for comparison to with a cohort of non-symptomatic volunteers to identify motion characteristics associated with pain, to correlate specific motion patterns with effective treatment strategies, and to better quantify clinical follow-up results. Such an approach has already proven its worth in the diagnosis and follow-up of joint arthroplasty patients via three-dimensional gait analysis. Identification of the characteristic motion patterns of a "normal" population will have additional benefits in the design of future non-rigid and dynamic spinal prostheses. The implementation of these newly developed methods will be assured through the close collaboration between the MEM Institute at the University of Bern and the Schulthess Clinic in Zürich. An extension of the project to years 4 & 5 is envisioned for the ongoing collection of and evaluation of patient data in clinical follow-up studies. |
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| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
SNF (Programm NFP) NFP53 "Musculoskeletal Health - Chronic Pain" |
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| Duration of Project / Projektdauer | Oct 2004 to Mar 2009 |