Could clinical ultrasound improve the fitting of spinal orthosis for the patients with AIS?

Li, M.; Cheng, Jack C. Y.; Ying, Michael; Ng, Bobby Kin Wah; Zheng, Yongping; Lam, TP; Wong, Wai Yin; Wong, Man Sang

doi:10.1007/s00586-012-2273-4

Cited by 38 publications

(31 citation statements)

References 22 publications

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“…This measurement was proposed to define the posterior deformity of the spine, which is what is visible during scoliosis surgery. The SPA was highly correlated with the Cobb angle for a wide range of curves, which recent studies have confirmed for moderate curves (20°-40°) [5,6]. However, the SPA value may underestimate the severity of scoliosis with large curvatures.…”

Section: Introductionmentioning

confidence: 73%

Correlation between Cobb angle, spinous process angle (SPA) and apical vertebrae rotation (AVR) on posteroanterior radiographs in adolescent idiopathic scoliosis (AIS)

et al. 2014

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Section: Introductionmentioning

confidence: 73%

Correlation between Cobb angle, spinous process angle (SPA) and apical vertebrae rotation (AVR) on posteroanterior radiographs in adolescent idiopathic scoliosis (AIS)

et al. 2014

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“…However, from the point of view of localization accuracy, we also measured a distance of 0.38 ± 0.4 mm between the centroids of the spinous process in the manually and automatically segmented images, demonstrating an accuracy and precision on the order of X-ray image resolution. This implies that measurements of the Spinous Process Angle, recommended by Li et al (2012) as a proxy to the Cobb angle, would be more accurate using our automatic method on ultrasound images than with manual landmark identification on X-ray images, currently used in clinical practice.…”

Section: Segmentation Resultsmentioning

confidence: 99%

“…Potential applications include deformity assessment (Ungi et al, 2014;Cheung et al, 2015;Young et al, 2015), spinal brace adjustment Li et al, 2012) and dense 3D spine surface reconstruction (Nguyen et al, 2015). The current gold standard measure for assessing scoliosis (as well as its progression or the effectiveness of a treatment) is the Cobb angle, measured on postero-anterior X-ray images.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the work cited above has focused on reproducing this measurement, or rather proxies of this measurement (e.g., using the Spinous Process Angle (Li et al, 2012), the Center of Laminae method (Nguyen et al, 2015) or the Transverse Process Angle (Ungi et al, 2014)), since the orientation of the vertebral endplates, which define the Cobb angle, cannot be visualized in ultrasound images. The proposed methods of measurement mirror what is typically done in clinical practice with the X-ray images, i.e., they are entirely based on the manual identification of anatomical features, which is time consuming and lacks repeatability.…”

Section: Introductionmentioning

confidence: 99%

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Segmentation of the spinous process and its acoustic shadow in vertebral ultrasound images

Berton

Cheriet

Marie-Claude

et al. 2016

Computers in Biology and Medicine

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Spinal ultrasound imaging is emerging as a low-cost, radiation-free alternative to conventional X-ray imaging for the clinical follow-up of patients with scoliosis. Currently, deformity measurement relies almost entirely on manual identification of key vertebral landmarks. However, the interpretation of vertebral ultrasound images is challenging, primarily because acoustic waves are entirely reflected by bone. To alleviate this problem, we propose an algorithm to segment these images into three regions: the spinous process, its acoustic shadow and other tissues. This method consists, first, in the extraction of several image features and the selection of the most relevant ones for the discrimination of the three regions. Then, using this set of features and a LDA classifier, each pixel of the image is classified as belonging to one of the three * Corresponding author Email addresses: florian.berton@polymtl.ca (Florian Berton), farida.cheriet@polymtl.ca (Farida Cheriet), marie-claude_miron@ssss.gouv.qc.ca regions. Finally, the image is segmented by regularizing the pixel-wise classification results to account for some geometrical properties of vertebrae. The feature set was first validated by analyzing the classification results across a learning database. The database contained 107 vertebral ultrasound images acquired with convex and linear probes. Classification rates of 84%, 92% and 91% were achieved for the spinous process, the acoustic shadow and other tissues, respectively. Dice similarity coefficients of 0.72 and 0.88 were obtained respectively for the spinous process and acoustic shadow, confirming that the proposed method accurately segments the spinous process and its acoustic shadow in vertebral ultrasound images. Furthermore, the centroid of the automatically segmented spinous process was located at an average distance of 0.38 mm from that of the manually labeled spinous process, which is on the order of image resolution. This suggests that the proposed method is a promising tool for the measurement of the Spinous Process Angle and, more generally, for assisting ultrasound-based assessment of scoliosis progression.

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“…For fitting braces, finite element computer models have been developed that may analytically test multiple types of braces to determine the optimal amount of force and pad placement within the brace [25][26][27][28][29][30][31][32][33]. Ultrasound has also been used to evaluate curve correction while patients are in a brace to check the efficacy of a brace in real time [34,35]. Objective compliance monitors have been developed for measuring temperatures or in-brace forces to monitor how often patients are wearing their braces in between follow-ups [36][37][38][39][40][41][42][43][44].…”

Section: Guidelines For Bracing Studiesmentioning

confidence: 99%

Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis

Chan

Lou

Hill

2013

Journal of Children's Orthopaedics

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Purpose To report on the current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis. Methods A comprehensive literature review was performed to determine the effectiveness of bracing, to report on imaging techniques that can assist in the assessment of bracing, to understand the roles of the biomechanical treatment concepts on bracing and to address the importance of the quality of life of the brace wearers. Results The effectiveness of bracing still remains controversial. Many technologies are still in development to improve the bracing process and quantify the effects of bracing. Imaging techniques with decreased or no radiation are promising in providing more frequent data on curve progression for patients. Computer-assisted design models have been used for both fitting and manufacturing the brace to patient contours. Ultrasound has been developed as a new means of diagnosing scoliosis and determining the effects of a brace on a patient's spine in real time. The brace treatment outcomes are correlated to the quantity and the quality of brace usage. Compliance monitors and force sensors have been developed to track the quality of brace usage. Improvements to brace wear also require consideration of patient quality of life. Surveys have been developed to describe the effects of family influence and selfimage on bracing effectiveness of patient quality of life. Conclusions Bracing remains a highly qualitative process, relying on the empirical judgment of the physicians and orthotists, along with buy-in with the patient. The suggested improvements will help to push bracing into a more evidence-based practice.

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Could clinical ultrasound improve the fitting of spinal orthosis for the patients with AIS?

Abstract: The 3D CUS could be considered as an effective, non-invasive and fast assessment method to scoliosis, especially in enhancing the effectiveness of orthotic treatment and its applications could also be further extended to other spinal deformities.

Cited by 38 publications

References 22 publications

Correlation between Cobb angle, spinous process angle (SPA) and apical vertebrae rotation (AVR) on posteroanterior radiographs in adolescent idiopathic scoliosis (AIS)

Correlation between Cobb angle, spinous process angle (SPA) and apical vertebrae rotation (AVR) on posteroanterior radiographs in adolescent idiopathic scoliosis (AIS)

Segmentation of the spinous process and its acoustic shadow in vertebral ultrasound images

Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis

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