UA139727U - METHOD OF THREE-DIMENSIONAL DIAGNOSIS OF DEFORMATION OF SPINE, CHEST AND PELVIS - Google Patents

Abstract

A method of three-dimensional diagnosis of spinal, thoracic and pelvic deformities involves determining the position of numerical anatomical landmarks by identifying them during a three-dimensional scan of the human body surface using a laser scanner. Prior to the study, the anatomical bone landmarks of the thorax, vertebral trunk and pelvic bones are pre-marked with embossed plastic, to obtain a digital three-dimensional model of deformation, from which transverse and longitudinal sections are programmed, followed by algorithmic calculation of required linear and angular parameters. .

Description

The useful model belongs to orthopedics and traumatology and can be used in medical institutions for the purpose of detection and dynamic monitoring of patients with pathology of the musculoskeletal system and during preventive examinations of children and adolescents.

There is a problem of examining a person with the aim of detecting pathological deviations on the side of the musculoskeletal system, the solution of which can be implemented without the use of harmful effects on the human body, with obtaining objective anthropometric data in the shortest possible period of time with minimal financial costs. This is especially relevant for examination to detect deformations of the spine, chest and pelvic bones.

A well-known method that uses the optical properties of light: "A method of computer optical topography of the shape of the human body and a device for its implementation" (Eurasian patent Mo 000111, 1998, the developer of the method is the Novosibirsk Research Institute of Traumatology and Orthopedics of the Ministry of Health of the Russian Federation).

The method is based on the use of a device consisting of an optical system, a complex of digital image processing and special software. The optical scheme includes a projector, a TV camera and an installation place for the examinee. The projector is used to project the image of vertical stripes onto the back. The TV camera reads the data obtained when the examinee's back is taken into the computer. The video display system is integrated into the system unit of the computer and provides input into the computer of images coming from the TV camera.

Entered images are stored in an archive on hard drives and then processed to obtain data in the form of halftone images and output forms with graphical and quantitative results.

This analogue has the following disadvantages: 1. The method is structurally complex, requires significant financial and material resources for its implementation due to the high cost of science-intensive software, and requires a specially equipped room with an area of 1,875.5 m. In addition, for the implementation of the specified method of diagnosis, there is a need for service personnel who know the examination method. 2. This method consists in surface registration of the relief of the trunk with subsequent digital processing and is carried out without prior marking of bony landmarks on the trunk.

The conclusion about changes in the vertebral trunk in this case is quite approximate, since bone changes do not always correlate with changes in the topography of the trunk. As an example, we can cite 5-shaped scoliosis of the I-II degree, in which the asymmetry of the relief of the trunk is minimal, with a pronounced deformation of the spine, which is explained by the presence of a compensatory arc of scoliosis, which minimizes the visual asymmetry of the trunk.

Another well-known analogue is "Method of assessment of funnel-shaped deformation of the chest", (VY 2492809, MPK Ab61B 5/107, АЭ1B 17/00) Authors: A.V. Gladkov, I.M. Zeltser.

The method consists in determining the degree of funnel-shaped deformation of the chest by scanning 15 established anatomical landmarks on the chest, spine and pelvic bones using the registration probe of the software and hardware complex "ZO Orthopedic Scanner" to obtain linear, angular and volumetric parameters characterizing the deformation chest and spine. This method has the following disadvantages: 1. Three-dimensional analysis of the deformation of the spine, chest and pelvic bones is not sufficiently objective, as it is carried out in isolation within the framework of 15 anatomical points, which are registered thanks to the indicator probe of the ZO-scanner. Thus, in the description of the anatomical landmarks of the spine, only three vertebrae are indicated - C7, TNa2 and 1 5, and among the landmarks of the pelvic bones, only two posterior spines of the pelvis are indicated. This fact, in our opinion, does not allow us to characterize in detail the numerical varieties of deformations of the chest, spine and pelvic bones.

The third known analogue "The method of digital diagnosis of spine deformations" is Russian

Federation (193 ATSSH(11)2392855(13)С1(51) IPC(2006.01) AbIV 5/103, author D.S. Melnikov,

Kanikin V.Yu.

The method is based on computer processing of digital images of the patient obtained with the help of a digital camera (camera) in three projections: straight back, left side and straight front. Previously, 7 point landmarks are placed on the patient's back along the spine. The location of landmarks is determined during palpation of the patient's spinous processes, followed by their marking. The received digital images are entered into the computer memory.

Landmark recognition is performed by the operator. As a result of the processing, a three-dimensional schematic image of the spine is obtained with an indication of deviations from the norm in millimeters and degrees.

This analogue has the following disadvantages:

1. The schematic three-dimensional model obtained as a result of digital processing of two-dimensional photographs with fixed 7 anatomical landmarks (which are not clearly described in the description of the method) is quite close to the real three-dimensional characteristics of the spine deformation, because it describes the location of the vertebral trunk in the two-dimensional coordinate system and does not reflect torsional (rotational) changes of the spine in the horizontal plane and accompanying deformations of the chest. 2. The use of a photoflash limits the use of the technique in patients with visual impairments, retinal pathology, and neurological diseases, because it can lead to a decrease in visual acuity and provoke convulsive attacks. 3. The useful model "Method of three-dimensional diagnosis of deformation of the spine, chest and pelvic bones" is based on the task of developing an effective, safe, fast and accurate method of three-dimensional diagnosis of disorders of the side of the spine, chest and pelvic bones, suitable for wide application in medical practice. 4. The task is solved by a method that includes determining the position of numerical anatomical landmarks by identifying them during a three-dimensional scan of the surface of the human body using a laser scanner, which is distinguished by the fact that before the study, anatomical bone landmarks of the chest, vertebral trunk and pelvic bones are pre-marked relief plastic, with obtaining a digital three-dimensional model of deformation, from which transverse and longitudinal sections are made by software, with further algorithmic calculation of the necessary linear, angular and volumetric parameters. 5. The method is carried out as follows: during the examination of the patient, the first stage of the study is carried out - the palpation identification of bony landmarks, to optimize this process, the patient was examined with the head and torso tilted forward, which contributes to better visualization of bony protrusions and facilitates their subsequent marking. Determination and marking is carried out in the back frontal plane: in the area of the head - the occipital protrusion, in the area of the cervical spine - the seventh cervical vertebra. In the back area, the following bony landmarks are determined: epicondyles of the humerus, acromial processes and lower angles of the scapulae, spinous processes of the thoracic vertebrae, in the presence of scoliotic deformation, the vertebra most deviated from the vertical level (the apex of the scoliotic deformation) is determined. In the projection

A rib "hump" characteristic of the 1st century is marked from the rib arches. scoliotic deformation. In the lumbar region, the following are determined: spinous processes of the vertebrae of the lumbar spine, elements of torsion of the vertebrae (muscular roller), posterior-upper spines of the iliac bones (lateral pits of the rhombus

Michaelis), the projection of the intersciatic fold.

In the front frontal plane, determine and mark: in the area of the head - the bridge of the nose, zygomatic humps, the middle of the chin. In the area of the chest: upper arm, jugular notch, sternal ends of the clavicles, in case of deformations of the chest - the top of the bony deformation of the sternum in case of keel-shaped deformation and a sunken point in case of funnel-shaped deformations. In the area of the pelvic girdle, the anterior-superior and posterior-superior spines of the iliac bones, large trochanters of the femurs and the pubic symphysis are noted.

In the sagittal plane, mark and mark - the protruding point of the forehead, the protruding point of the chin, the goatee, the cervical lordosis point that is distant to the front, the thoracic kyphosis point that is distant to the back, the lumbar lordosis point that is distant to the front.

Marking of the determined landmarks is carried out with a relief fragment of square plastic measuring 2.072.0 cm on an adhesive base, which protrudes above the surface of the patient's skin by 1.5 cm and is subsequently reliably determined on a three-dimensional scanogram.

The patient is in a natural vertical position: mobility of the upper limbs during scanning is not allowed, the head is fixed so that the upper edge of the auricle is on the same horizontal line as the lower edge of the eye orbit. After marking the specified bony landmarks on the skin of the subject, the technical capabilities of the well-known household three-dimensional scanner 3О-5sappeg KhMUrgipipt are used to obtain a digital model of the body, which includes a scanning head (a source of laser radiation and a digital video camera), a handle and an O5V connector that connects the scanner with

EVM. The researcher, holding the scanner in his hand, performs rotational movements around the patient's body, grasping the desired scanning area. The scanner is connected to a computer based on the Ipivey Soge 5-4 generation processor with the operating system MUipdomye 8 or higher (64 ri) and is controlled using software. The quality of scanning is controlled thanks to the image of the scanned object in the working window of the program of the company-developer of the scanner KhmUrgipiptud. After scanning, the object is saved on the hard disk of the computer in OB format). In the future, the anthropometric processing of the three-dimensional object takes place according to the software developed by us.

To perform a cross-section of a three-dimensional model of the back, it is necessary to open Roparie Echessavrie (program application). The main graphical window will be displayed, where the controls are located.

Before starting work, it is necessary to select the plane of the future section using the RadiovVinop components grouped in the "Sectional plane" area: "Horizontal", "Sagittal", "Frontal"). (Fig. 1). After selecting the section plane, the user clicks the "Open file" button and selects the OV.) file containing the three-dimensional model. The program opens the OV.) file in text representation and sequentially reads the coordinates from the "y" section of the file into the array of vertices. After reading the file, the appropriate coordinate pairs are selected for the corresponding section plane (for the convenience of sectioning, the model is displayed in the plane that is best suited for sectioning). According to the selected coordinate pairs, the array of vertices is displayed in a two-dimensional representation on the TItade component. A grid setting is optional and can be set by the user using the Grid Setting tool in the Tool Selection area.

The grid is set by successive selection of two points corresponding to a distance of 10 cm by pressing the left and right mouse buttons. After the grid is set, at any time the user can measure the distance between two points by selecting the appropriate tool in the Tool Selection area.

Setting the points for measuring the distance is done by sequentially pressing the left and right mouse buttons. The cut is performed with the appropriate tool in the "Tool Selection" area. After selecting the Cut tool, two parallel cut lines appear in the area of the Titade component (Fig. 2).

The identification and digitization of anatomical landmarks occurs as follows: in the frontal plane in the working window of the program, the following 11 landmarks are marked and digitized on the three-dimensional image - the occipital protrusion, the projection of the beginning of the ischial fold, the epicondyle of the humerus, the acromial processes and the lower corners of the scapulae, the spinous process of the thoracic vertebra , which is apical in scoliotic deformation, waist triangles, posterior-superior spines of the iliac bones.

In the sagittal plane on the three-dimensional image, 6 landmarks are marked and digitized -

From the protruding point of the forehead, the protruding point of the chin, the goatee, the remote forward point of the cervical lordosis, the remote backward point of the thoracic kyphosis, the remote forward point of the lumbar lordosis. At the end of such a procedure, an automated measurement of the specified parameters is performed, followed by their graphic visualization. Measurement of linear dimensions is performed by specifying two points - the beginning and end of the line. Angle parameters are measured at three points: the apex of the angle and two points on the sides of the angle. In the frontal plane, the following 5 parameters are calculated: 1) the coefficient of asymmetry of the upper arms (sy); 2) coefficient of asymmetry of the lower angles of the blades (02); 3) pelvic asymmetry coefficient (az); 4) the size of the waist triangle on the left - I 1; 5) the size of the waist triangle on the right is 12.

Example Me 1. On the frontal scanogram of the patient G-ko, the following indicators are determined: I. (sy) - angle of asymmetry of the upper arms - 3.29 g; 2. (ag) - blade asymmetry angle - 8.57g; 3. (az) angle of asymmetry of the pelvis - 1.0 g; 4. (I) waist triangle on the left - 8.4 mm; 5. (I 2) waist triangle on the right - 9.6 mm (Fig. C)

In the sagittal plane, C indicators are analyzed: 1) the value of cervical lordosis (Mi); 2) the value of lumbar lordosis (M2); 3) the magnitude of thoracic kyphosis (M3);

Example Mo 2. On the sagittal scanogram of the patient G-ko, the following indicators are determined: 1. (M1) - the height of the cervical lordosis - 81.89 mm; 2. (M3) - height of thoracic kyphosis - 78.74 mm; 3. (M2) - lumbar lordosis height - 73.23 mm (Fig. 4).

If patients have a funnel-shaped deformity, a separate diagnostic algorithm is used, according to which we calculate an analogue of Haller's CT index (I //) based on the horizontal sections of the torso obtained during software processing: the ratio of the transverse size of the chest (11) to its anterior-posterior size ( NO). In the case of its value of 23.25, operative correction of the deformation is indicated. An example of calculating an analogue of the Haller index for funnel-shaped deformation, according to the software algorithm, is shown in Fig. 5.

If there is a wedge-shaped deformation of the chest, we determine this indicator similarly, and if the value of this index exceeds 1.11 (II degree of wedge-shaped deformation), the patient is indicated for operative correction of the chest deformation. An example of calculating an analogue of the Haller index for wedge-shaped deformation, according to the software algorithm, is given on

Fig. 6.

As a result of the study, we will receive scanograms of the patient's body surface in the frontal, sagittal and horizontal planes and linear and angular anthropometric parameters calculated using the program algorithm. Anthropometry parameters are automatically fixed within the three-dimensional research protocol and entered into a single database on the hard disk of the computer.

Passport data, such as date of birth (date, month, year of birth), number of complete years, address of residence and date of examination, as well as morphometric indicators (height in centimeters, body weight in kilograms) are also recorded in the protocol of the three-dimensional examination. A separate item is the evaluation of the obtained data, according to which the signs of progression, stabilization or regression of the deformation are ascertained, as well as indications for observation, conservative or operative treatment are formulated, according to the parameters of the study.

Claims (1)

USEFUL MODEL FORMULA A method of three-dimensional diagnosis of deformation of the spine, chest and pelvic bones, which includes determining the position of numerical anatomical landmarks by identifying them during three-dimensional scanning of the surface of the human body using a laser scanner, which differs in that prior to the study, anatomical bone landmarks are pre-marked chest, vertebral trunk and pelvic bones with relief plastic, obtaining a digital three-dimensional model of deformation, from which transverse and longitudinal sections are made by software, with further algorithmic calculation of the necessary linear, angular and volumetric parameters. and ! Isheh 000 pnunutkek pedrchettnya M: Fig. 1