RU2272563C1 - Method for examining locomotor system in sagittal plane by applying topographic photometry approach - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves marking reference points like spinous process apex C7, spinous process apex D7, spinous process apex D12, spinous process apex L4, spinous process apex S1. Patient back picture is taken with digital camera and displayed on computer screen. The received image is processed by building contour plots and three-dimensional image in sagittal plane. Relations and angles between the reference points: distance from D7 to vertical line, distance from L4 to vertical line, angle between C7-D7 line and horizontal plane, angle between D7-D12 line and horizontal plane, angle between D12-L4 line and L4-S1, angle between C7-D12 line and vertical line, angle between D12-S1 line and angle between C7-S1 line and vertical line. The received data are interpreted in terms of locomotor system state.

EFFECT: complete data describing locomotor system state in sagittal plane.

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Description

The invention relates to medicine, namely to traumatology and orthopedics.

Currently, computer topographic analysis of deformations of the human body (topographic photometry) is widely used in the diagnosis of disorders of the structure of the musculoskeletal system (M.B.Tsykunov, O.A. Malakhov, B.A. Polyaev, E.Yu.Sergeenko, O .V. Volchenkova. Diagnosis and correction of posture disorders. - M .: RASMIRBI. 2003, S.64-65), and is also used in assessing the condition of the spine in the sagittal plane and the statics of the patient as a whole.

As an analogue in the practice of medical hospitals, the x-ray method is used (N.A. Tager, V.A. Dyachenko. X-ray diagnosis of diseases of the spine. - M .: Medicine, 1971, S.3-15).

This method is accepted by us as a prototype. However, it has the following disadvantages:

- the possibility of examining a maximum of two to three sections of the spine does not give an idea about the disorders of the musculoskeletal system in the sagittal plane as a whole and about the change in the projection of the center of gravity.

- the need to produce profile shots in compliance with the same technical conditions (distance, exposure, etc.), high quality requirements for shots.

- significant radiation exposure during the examination does not make it possible to carry out radiography several times a year to determine the dynamics of the process and evaluate the effectiveness of the treatment.

Thus, we can conclude that the x-ray method does not fully provide information on the condition of the patient’s musculoskeletal system in the sagittal plane, and also does not allow to evaluate the treatment results and use the optimal correction method.

Based on the fact that an important place in the diagnosis and treatment of pathology of the musculoskeletal system is the assessment of its condition in the sagittal plane (M. B. Tsykunov, O. A. Malakhov, B. A. Polyaev. Diagnosis and conservative correction of static deformations. - M .: RASMIRBI. 2004, P.67), indicating that deformations of the spine in the sagittal plane with functional insufficiency of the musculo-ligamentous apparatus are accompanied by impaired posture and impaired respiratory function, we use to diagnose and evaluate the effectiveness of method of topographic photometry is proposed for the deformation of the musculoskeletal system in the sagittal plane.

Performing topographic photometry during the examination of the patient has significant differences from the prototype.

The method is as follows.

At the beginning of the examination, the doctor puts markers on the bone landmarks (see figure 1 with the reference points used in the technique of topographic photometry):

- the tip of the spinous process of C7.

- apex of the spinous process D7.

- apex of the spinous process D12.

- the apex of the spinous process L4 (at the point of intersection of the line passing through the upper edges of the iliac crests with the plumb line).

- the apex of the spinous process S1 (at the point of intersection of the line passing through the posterior lower iliac spines with the plumb line).

Work algorithm:

1. photographing the back of the patient.

2. image output from the digital camera to the computer monitor screen and entering information into the database.

3. processing of the resulting image: contouring, setting landmarks and programmatically constructing a three-dimensional image with the subsequent calculation of a number of ratios and angles between landmarks.

4. clinical report.

Initial position of the patient and testing methods.

Starting position - standing, heels and socks are parallel and are on the same horizontal level, the distance between the inner edges of the feet is 5-6 cm, hands are lowered freely down. Several parameters are evaluated (see Fig. 2, which shows the main lines and angles in the sagittal plane used in the method of topographic photometry):

- thoracic kyphosis (distance from D7 to the vertical specified by the program).

- lumbar lordosis (distance from L4 to vertical).

- tilt to the frontal plane of the upper thoracic spine (along the angle between the C3-D7 line and the horizontal plane).

- tilt to the frontal plane of the lower thoracic spine (along the angle between the line D7-D12 and the horizontal plane).

- lumbar angle (between the line D12-L4 and L4-S1).

- sagittal inclination of the thoracic spine (between the C7-D12 line and the vertical).

- the sagittal tilt of the lumbar spine (between the D12-S1 line and the vertical).

- total angle of sagittal tilt (between the C7-S3 line and the vertical).

After the examination, depending on the data obtained, a clinical conclusion is made:

- Harmonious posture with moderate cervical and lumbar lordosis.

- Flat back. The physiological bends of the spine are weakly expressed, the head is slightly inclined anteriorly, as a result of which cervical lordosis is weakly expressed.

- Slouching back. The thoracic kyphosis is enhanced, the lordosis of the lumbar is slightly flattened, the trunk and especially the shoulder girdle are shifted anteriorly, the total angle of sagittal tilt indicates a deviation of the projection of the center of gravity anteriorly.

- Round-concave back. The pelvis is significantly inclined anteriorly, as a result of which the lumbar lordosis is strengthened, the kyphosis of the thoracic spine is compensatoryly increased. The total angle of sagittal tilt open shows the deviation of the trunk posteriorly.

- Round back. The lumbar lordosis is smoothed, the entire spine is kyphosed.

Specifications. To conduct topographic photometry, we used the Super M hardware-software complex, which incorporates an Olimpic digital camera and a projector, the system is supported by Windows 98 software.

Results: During the period from January to July 2004, we examined 167 patients aged 5 to 49 years with various pathologies of the musculoskeletal system. After taking pictures of the patient’s usual posture, the program performed calculations and, according to the topograms, we found harmonious posture in 59 patients, 56 stooped posture, 38 changes in the type of round-concave back, 10 in the type of round back, and in 4 - flat posture according to the proposed conclusion setting scheme.

Thus, we have shown the advantages of the proposed method of topographic photometry in the diagnosis of the musculoskeletal system in the sagittal plane, its practical feasibility and clinical usefulness.

Claims (1)

A method of examining the musculoskeletal system to assess its condition, characterized in that it sets landmarks: the tip of the spinous process C7, the tip of the spinous process D7, the tip of the spinous process D12, the tip of the spinous process L4, the tip of the spinous process S1, then photograph the patient’s back digitally camera and display the image on a computer monitor screen, process the resulting image by contouring and building a three-dimensional image in the sagittal plane, calculate the ratios and angles between landmarks: distance from D7 to vertical, distance from L4 to vertical, angle between line C7-D7 and horizontal plane, angle between line D7-D12 and horizontal plane, angle between line D12-L4 and L4-S1, angle between line C7-D12 and the vertical, the angle between the line D12-S1, the angle between the C7-S1 line and the vertical, and the state of the musculoskeletal system is estimated from the obtained data.

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