Avaliação cinemática da coluna vertebral por análise de imagem: algoritmo e validação
Ficheiros
Data
2018-02-02
Título da revista
ISSN da revista
Título do Volume
Editora
Resumo
Atualmente as patologias associadas à coluna vertebral são cada vez mais comuns. Uma das estruturas que mais afeta a qualidade de vida dos pacientes é o disco intervertebral, sendo por isso, importante desenvolver ferramentas e métodos que ajudem a avaliar mais eficazmente o seu estado e perceber como atuar para melhorar a qualidade de vida dos pacientes. A estrutura da coluna vertebral é complexa, pois é constituída por vários elementos que permitem ao ser humano manter a posição ereta e caminhar. Para além disso, ainda protege elementos importantes do sistema nervoso. Um dos elementos da coluna que permite o movimento é o disco intervertebral, pois atua como uma junta entre as vértebras, reduzindo a fricção e absorvendo os impactos. Quando estes elementos são danificados é necessário intervir de forma a que o paciente não perca a possibilidade de se movimentar. Para tal existem vários métodos de tratamento, sendo os mais utilizados a artrodese e a artroplastia. O primeiro consiste na remoção do disco e união das vértebras adjacentes, e o segundo consiste na colocação de um dispositivo médico que tenta replicar as funções do disco intervertebral. Este estudo consistiu na criação de um programa que permite avaliar o estado dos pacientes que sofrem de patologias ao nível dos discos intervertebrais. Esse programa possui algoritmos que permitem melhorar a qualidade das imagens obtidas através da técnica de raio X, e algoritmos que obtêm os parâmetros cinemáticos da coluna vertebral. Os algoritmos responsáveis por fornecer os parâmetros cinemáticos da coluna, que consistem nos centros de rotação e na amplitude de movimento, foram devidamente testados em condições ideais, onde não existe ruído nos dados fornecidos, e em condições mais próximas da realidade onde os dados contêm ruído, apresentando todos eles uma boa precisão e fiabilidade. Posteriormente é feito um teste ao programa, onde são gerados quatro conjuntos de imagens artificiais em extensão e flexão, que pretendem simular as vértebras da coluna vertebral, e que vai de uma unidade funcional até quatro. O programa foi testado nestas quatro situações de forma a verificar de que forma se comporta quando é deparado com várias unidades funcionais. Os testes demonstraram que para duas e três unidades funcionais, os dados obtidos entre os diferentes algoritmos se aproximam mais entre si do que para uma e quatro unidades funcionais. Foi também testado um caso real em que o paciente sofreu uma intervenção cirúrgica ao nível da coluna cervical. Foi avaliada a evolução do paciente ao longo de três estágios, pré-operatório, pós-operatório imediatamente a seguir à cirurgia e três meses após o procedimento, sendo os resultados obtidos satisfatórios e dentro do previsto. Os resultados obtidos nos casos estudados por este programa foram eficazes, o que demonstrou que o VisualVertebra é uma ferramenta eficiente e que pode contribuir no auxílio clínico, na avaliação da qualidade de movimento da coluna.
Nowadays the patologys associated with the vertebral column are more and more common. One of the structures that affects the most the quality of life of the pacients is the intervertebral disc, therefore, it’s important to develop tools and methods that help to assess more eficiently their condition and how to act to improve the quality of life of the pacients. The structure of the vertebral column it’s complex, since it is constituted by several elements that allows the human being to stand in an upright position and walk. It also protects essential elements of the nervous sistem. One of the elements of the spine that allows movement is the intervertebral disc, acting as a joint between the vertebrae, reducing friction and absorving impacts. When these elements are damaged it is necessary to intervene in a way that the pacient doesn’t lose the ability to move. Therefore, several treatment methods exist, being the most used the athrodesis and arthroplasty. The first one consists in removing the disc and union of the adjacent vertebrae, the second one consists in the replacement of the disc with a medical device that tries to replicate the functions of the intervertebral disc. This study has consisted in the criation of a program that allows to evaluate the condition of the pacients that suffer from patologies in the intervertebral discs. This program uses algorithms that enhance the quality of the obtained X-ray images, and algorithms that obtain kinematic parameters of the vertebral column. The algorithms responsible for providing the kinematic parameters of the spine, that consist in the centers of rotation and range of motion, were properly tested in ideal conditions, where there’s no noise in the provided data, and in closer to real conditions where the data contains noise, all presenting good precision and liability. Afterwards a test is performed on the program, where four sets of images are generated in extension and flexion, in an attempt to simulate the vertebrae of the vertebral column, going from one functional unit to four. The program was tested in these four conditions, to check how the program behaves when it is presented with multiple functional units. The tests demonstrated that for two and three functional units, the obtained data between the diferent algorithms came closer to each other than for one or four functional units. It was also tested a real case scenario where the pacient went over a surgical intervention on the cervical spine. The evolution of the pacient was evaluated throughout three stages, pre-operative, post-operative immediately after the surgery and three months after the procedure, showing satisfatory results and within expected. The results obtained in the cases studied by this program were effective, wich demonstrated that VisualVertebra is an efficient tool and it can contribute to the clinical aid, on the evaluation of the spinal motion quality.
Nowadays the patologys associated with the vertebral column are more and more common. One of the structures that affects the most the quality of life of the pacients is the intervertebral disc, therefore, it’s important to develop tools and methods that help to assess more eficiently their condition and how to act to improve the quality of life of the pacients. The structure of the vertebral column it’s complex, since it is constituted by several elements that allows the human being to stand in an upright position and walk. It also protects essential elements of the nervous sistem. One of the elements of the spine that allows movement is the intervertebral disc, acting as a joint between the vertebrae, reducing friction and absorving impacts. When these elements are damaged it is necessary to intervene in a way that the pacient doesn’t lose the ability to move. Therefore, several treatment methods exist, being the most used the athrodesis and arthroplasty. The first one consists in removing the disc and union of the adjacent vertebrae, the second one consists in the replacement of the disc with a medical device that tries to replicate the functions of the intervertebral disc. This study has consisted in the criation of a program that allows to evaluate the condition of the pacients that suffer from patologies in the intervertebral discs. This program uses algorithms that enhance the quality of the obtained X-ray images, and algorithms that obtain kinematic parameters of the vertebral column. The algorithms responsible for providing the kinematic parameters of the spine, that consist in the centers of rotation and range of motion, were properly tested in ideal conditions, where there’s no noise in the provided data, and in closer to real conditions where the data contains noise, all presenting good precision and liability. Afterwards a test is performed on the program, where four sets of images are generated in extension and flexion, in an attempt to simulate the vertebrae of the vertebral column, going from one functional unit to four. The program was tested in these four conditions, to check how the program behaves when it is presented with multiple functional units. The tests demonstrated that for two and three functional units, the obtained data between the diferent algorithms came closer to each other than for one or four functional units. It was also tested a real case scenario where the pacient went over a surgical intervention on the cervical spine. The evolution of the pacient was evaluated throughout three stages, pre-operative, post-operative immediately after the surgery and three months after the procedure, showing satisfatory results and within expected. The results obtained in the cases studied by this program were effective, wich demonstrated that VisualVertebra is an efficient tool and it can contribute to the clinical aid, on the evaluation of the spinal motion quality.
Descrição
Palavras-chave
Coluna Vertebral , Biomecânica da Coluna , Processamento de Imagem , Python , Algoritmo , VisualVertebra