Simulation of a Bead Placement Protocol for Follow-up of Thoracic Spinal Fusion Using Radio stereometric Analysis
Tóm tắt
Computer simulation to detect intervertebral motion enabling future follow-up of spinal fusions performed on patients with multilevel thoracic scoliosis. To propose a method using computer simulation to evaluate a radiostereometric analysis (RSA) marker placement protocol for visibility and redundancy and validate the performance of the developed RSA system in detecting intervertebral motion. Radiostereometric analysis is a stereo x-ray technique in which clusters of tantalum markers are implanted to label well-defined landmarks and measure the relative motion between rigid bodies. A model of the spine with the instrumentation and the RSA markers was developed. The vertebrae were aligned to mimic multilevel thoracic scoliosis after correction. The researchers performed virtual segment motion to validate the performance of the developed system. X-ray images were simulated and RSA was used to evaluate the proposed marker placement protocol and detect virtual motion. The authors performed a physical phantom study to evaluate marker visibility. All markers were located and matched between simulations and the condition numbers were well below the recommended value of 100. Based on computer simulation, average translational accuracy was 0.14, 0.01, and 0.24 mm along the x, y, and z axes, respectively, and average rotational accuracy was 0.23°, 0.12°, and 0.11° about the x,y, and z axes, respectively. The translational and rotational precision of the simulated RSA system was generally high. The physical phantom study agreed with the computer simulation and validated marker visibility. Computer simulation is a powerful tool that can be used to facilitate the development and refinement of an RSA system before its application in patients, particularly when the anatomy involved is complex. The proposed marker placement protocol yielded translational and rotational accuracy below the limits of clinical significance, which enables future follow-up of multilevel thoracic scoliosis with Lenke classification IAN.
Tài liệu tham khảo
Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 1962;44:591–610.
Kuklo TR, Potter BK, Lenke LG, et al. Surgical revision rates of hooks versus hybrid versus screws versus combined anteroposterior spinal fusion for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2007;32:2258–64.
Mulpuri K, Perdios A, Reilly CW. Evidence-based medicine analysis of all pedicle screw constructs in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2007;32(19 suppl):S109–14.
Vora V, Crawford A, Babekhir N, et al. A pedicle screw construct gives an enhanced posterior correction of adolescent idiopathic scoliosis when compared with other constructs: myth or reality. Spine (Phila Pa 1976) 2007;32:1869–74.
Skaggs D. Posterior spinal fusion was not improved by supplemental bone graft in adolescent idiopathic scoliosis. J Bone Joint Surg Am 2006;88:2313.
Suk SI, Lee CK, Kim WJ, et al. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 1995;20:1399–405.
Lang P, Chafetz N, Genant HK, Morris JM. Lumbar spinal fusion: assessment of functional stability with magnetic resonance imaging. Spine (Phila Pa 1976) 1990;15:581–8.
Brodsky AE, Kovalsky ES, Khalil MA. Correlation of radiologic assessment of lumbar spine fusions with surgical exploration. Spine (Phila Pa 1976) 1991;16(6 suppl):S261–5.
Hilding MB, Yuan X, Ryd L. The stability of three different ce-mentless tibial components: a randomized radiostereometric study in 45 knee arthroplasty patients. Acta Orthop Scand 1995;66:21–7.
Rish BL. A critique of posterior lumbar interbody fusion: 12 years’ experience with 250 patients. Surg Neurol 1989;31:281–9.
Brantigan JW, Steffee AD, Lewis ML, et al. Lumbar interbody fusion using the Brantigan I/F cage for posterior lumbar interbody fusion and the variable pedicle screw placement system: two-year results from a Food and Drug Administration investigational device exemption clinical trial. Spine (Phila Pa 1976) 2000;25:1437–46.
Pape D, Fritsch E, Keim J, et al. Lumbosacral stability of consolidated anteroposterior fusion after instrumentation removal determined by roentgen stereophotogrammetric analysis and direct surgical exploration. Spine (Phila Pa 1976) 2002;27:269–74.
Axelsson P, Karlsson BS. Intervertebral mobility in the progressive degenerative process: a radiostereometric analysis. Eur Spine J 2004;13:567–72.
Johnsson R, Strömqvist B, Axelsson P, Selvik G. Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion: a roentgen stereophotogrammetric and radiographic analysis. Spine (Phila Pa 1976) 1992;17:16–21.
Lee S, Harris KG, Goel VK, Clark CR. Spinal motion after cervical fusion: in vivo assessment with roentgen stereophotogrammetry Spine (Phila Pa 1976) 1994;19:2336–42.
Johnsson R, Selvik G, Strömqvist B, Sunden G. Mobility of the lower lumbar spine after posterolateral fusion determined by roentgen stereophotogrammetric analysis. Spine (Phila Pa 1976) 1990;15:347–50.
Gunnarsson G, Axelsson P, Johnsson R, Strömqvist B. A method to evaluate the in vivo behaviour of lumbar spine implants. Eur Spine J 2000;9:230–4.
Zoega B, Karrholm J, Lind B. Mobility provocation radio-stereometry in anterior cervical spine fusions. Eur Spine J 2003;12:631–6.
Johnsson R, Axelsson P, Gunnarsson G, Strömqvist B. Stability of lumbar fusion with transpedicular fixation determined by roentgen stereophotogrammetric analysis. Spine (Phila Pa 1976) 1999;24:687–90.
Leivseth G, Kolstad F, Nygaard OP, et al. Comparing precision of distortion-compensated and stereophotogrammetric Roentgen analysis when monitoring fusion in the cervical spine. Eur Spine J 2006;15:774–9.
Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 2001;83:1169–81.
Breglia DP. Generation of a 3-D parametric solid model of the human spine using anthropomorphic parameters. In: Fritz J, Dolores H, editors. Ohio: Russ College of Engineering and Technology, Ohio University; 2006.
Panjabi MM, Goel V, Oxland T, et al. Human lumbar vertebrae: quantitative three-dimensional anatomy. Spine (Phila Pa 1976) 1992;17:299–306.
Panjabi MM, Takata K, Goel V, et al. Thoracic human vertebrae: quantitative three-dimensional anatomy. Spine (Phila Pa 1976) 1991;16:888–901.
Johnsson R, Stromqvist B, Aspenberg P. Randomized radiostereo-metric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in Clinical Studies. Spine (Phila Pa 1976) 2002;27:2654–61.
Soderkvist I, Wedin PA. Determining the movements of the skeleton using well-configured markers. J Biomech 1993;26:1473–7.
Valstar ER, Gill R, Ryd L, et al. Guidelines for standardization of radiostereometry (RSA) of implants. Acta Orthop 2005; 76: 563–72.
Greiner KA. Adolescent idiopathic scoliosis: radiologic decisionmaking. Am Fam Physician 2002;65:1817–22.