The measurement of the kinematics of the human spine using video fluoroscopy and image processing

Abstract

The motion between the segments of the human spine intimately reflects the state of their soft-tissue linkages. Despite this, the diagnosis of mechanical disorders of the spine suffers from lack of acceptable ways of quantifying such intersegmental motion in living subjects. This thesis establishes a technique for obtaining such kinematic information by extrapolating from co-ordinates placed on digitised images from X-ray motion sequences. This provides a low radiation-dose, accurate and detailed method for the analysis of the kinematics of the lumbar spine in the coronal and sagittal planes and of the cervical spine in the saggittal plane. The technique, in addition, reduces the operator involvement with measurement and calculation traditionally associated with such issues.

The indices used in this thesis are intervertebral angles and instantaneous centres of rotation (ICRs). Using a calibration model and human volunteer subjects the possibility for determining the former to an accuracy of 2^o was established. For ICRs, provided the rotation of the segment in question exceeds 7^o, the error and variation in their determination is consistently less than the range of currently accepted normality.

Examples of detailed intersegmental motion patterns in asymptomatic and symptomatic human subjects are given and tentative interpretations offered. However, the clinical relevance of such findings must await the application of perhaps future generations of this system to large numbers of patients suffering from mechanical disorders of the spine.

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