Reproducibility of Standing Posture for X-Ray Radiography: A Feasibility Study of the BalancAid with Healthy Young Subjects

Dewi, Dyah Ekashanti Octorina; Veldhuizen, Albert G.; Burgerhof, Johannes G. M.; Purnama, Iwan; Ooijen, Peter M. A. van; Wilkinson, Michael H. F.; Mengko, Tati L. R.; Verkerke, Gijsbertus Jacob

doi:10.1007/s10439-010-0062-y

Cited by 13 publications

(6 citation statements)

References 23 publications

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“…Given the high impact of a reproducible posture, several authors have provided practical recommendations for patient positioning during radiography. Dewi et al [ 34 ] suggested a balancing plate that comprises a square board with a cylindrical disk at the center point attached at the center of the bottom. This design was aimed at realizing a forced balance in the sagittal and frontal planes.…”

Section: Possible Reasons For the Failure Of The Current Sagittal Defmentioning

confidence: 99%

Spinal Deformity Surgery: A Critical Review of Alignment and Balance

2018

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Correction of the overall coronal and/or sagittal plane deformities is one of the main predictors of successful spinal surgery. In routine clinical practice, spinal alignment is assessed using several spinal and pelvic parameters, such as pelvic incidence and tilt, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis. Standard values have been defined for all these parameters, and the formulas of correction have been set for determining the surgical strategy. However, several factors can potentially bias these formulas. First, all standard values are measured using conventional plain radiographs and are, therefore, prone to bias. The radiologist, measuring surgeon, and patient are possible confounding influencing factors. Second, spino-pelvic compensatory effects and biomechanically relevant structures for the patient’s posture, including ligaments, tendons, and muscles, have received minimal consideration in the literature. Therefore, even in cases of appropriately planned deformity correction surgeries, complications, revision rates, and surgical outcomes significantly vary. This study aimed to illustrate the current clinical weaknesses of the assessment of spinal alignment and the importance of holistically approaching the musculoskeletal system for any spinal deformity surgery. We believe that our detailed insights regarding spinal, sagittal, and coronal alignments as well as the considerations of an individual’s spinal balance will contribute toward improvement in routine patient care.

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Section: Possible Reasons For the Failure Of The Current Sagittal Defmentioning

confidence: 99%

Spinal Deformity Surgery: A Critical Review of Alignment and Balance

2018

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“…[ 3 ] It is not unheard of for patients to report that their previous chiropractor informed them their pelvis is “misaligned” or “rotated.” Various factors can influence this extremely dogmatic approach to a patient’s assessment, including alteration of patient positioning, variation in an individual’s anatomy, inter-examiner reliability, and overall image quality. [ 8 - 12 ]…”

Section: Introductionmentioning

confidence: 99%

An investigation into the chiropractic practice and communication of routine repetitive radiographic imaging for the location of postural misalignments

Williams,

Gichard,

Johnson

et al. 2024

JCIS

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Many clinicians use radiological imaging in efforts to locate and diagnose the cause of their patient’s pain, relying on X-rays as a leading tool in clinical evaluation. This is fundamentally flawed because an X-ray represents a “snapshot” of the structural appearance of the spine and gives no indication of the current function of the spine. The health and well-being of any system, including the spinal motion segments, depend on the inter-relationship between structure and function. Pain, tissue damage, and injury are not always directly correlated. Due to such a high incidence of abnormalities found in asymptomatic patients, the diagnostic validity of X-rays can be questioned, especially when used in isolation of history and/or proper clinical assessment. The utility of routine X-rays is, therefore, questionable. One may posit that their application promotes overdiagnosis, and unvalidated treatment of X-ray findings (such as changes in postural curvature), which may mislead patients into believing these changes are directly responsible for their pain. A substantial amount of research has shown that there is no association between pain and reversed cervical curves. Accuracy can also be questioned, as X-ray measurements can vary based on the patient’s standing position, which research shows is influenced by an overwhelming number of factors, such as patient positioning, patient physical and morphological changes over time, doctor interreliability, stress, pain, the patient’s previous night’s sleep or physical activity, hydration, and/or emotional state. Furthermore, research has concluded that strong evidence links various potential harms with routine, repeated X-rays, such as altered treatment procedures, overdiagnosis, radiation exposure, and unnecessary costs. Over the past two decades, medical boards and health associations worldwide have made a substantial effort to communicate better “when” imaging is required, with most education around reducing radiographic imaging. In this review, we describe concerns relating to the high-frequency, routine use of spinal X-rays in the primary care setting for spine-related pain in the absence of red-flag clinical signs.

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“…For the purpose of additional validation, three new CT scans were added, each paired with the corresponding two natural X-ray images of the same bone as in the CT scan; the first natural X-ray image showed the bone from the anteroposterior and the second from the mediolateral view. Using the software MeVisLab, we generated 900 artificial 2D X-ray images for each of the 29 CT scans by varying the viewing angle and radiation exposure, thus simulating the variability of conditions during clinical X-ray image acquisition 32,33 . These 26,100 images served as the dataset to train and evaluate the neural network on.…”

Section: Resultsmentioning

confidence: 99%

Estimating and abstracting the 3D structure of feline bones using neural networks on X-ray (2D) images

et al. 2020

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Computing 3D bone models using traditional Computed Tomography (CT) requires a highradiation dose, cost and time. We present a fully automated, domain-agnostic method for estimating the 3D structure of a bone from a pair of 2D X-ray images. Our triplet loss-trained neural network extracts a 128-dimensional embedding of the 2D X-ray images. A classifier then finds the most closely matching 3D bone shape from a predefined set of shapes. Our predictions have an average root mean square (RMS) distance of 1.08 mm between the predicted and true shapes, making our approach more accurate than the average achieved by eight other examined 3D bone reconstruction approaches. Each embedding extracted from a 2D bone image is optimized to uniquely identify the 3D bone CT from which the 2D image originated and can serve as a kind of fingerprint of each bone; possible applications include faster, image content-based bone database searches for forensic purposes.

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Reproducibility of Standing Posture for X-Ray Radiography: A Feasibility Study of the BalancAid with Healthy Young Subjects

Cited by 13 publications

References 23 publications

Spinal Deformity Surgery: A Critical Review of Alignment and Balance

Spinal Deformity Surgery: A Critical Review of Alignment and Balance

An investigation into the chiropractic practice and communication of routine repetitive radiographic imaging for the location of postural misalignments

Estimating and abstracting the 3D structure of feline bones using neural networks on X-ray (2D) images

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