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The Influence of Kinematic Constraints on Model Performance During Inverse Kinematics Analysis of the Thoracolumbar Spine.

ABSTRACT: Motion analysis is increasingly applied to spine musculoskeletal models using kinematic constraints to estimate individual intervertebral joint movements, which cannot be directly measured from the skin surface markers. Traditionally, kinematic constraints have allowed a single spinal degree of freedom (DOF) in each direction, and there has been little examination of how different kinematic constraints affect evaluations of spine motion. Thus, the objective of this study was to evaluate the performance of different kinematic constraints for inverse kinematics analysis. We collected motion analysis marker data in seven healthy participants (4F, 3M, aged 27-67) during flexion-extension, lateral bending, and axial rotation tasks. Inverse kinematics analyses were performed on subject-specific models with 17 thoracolumbar joints allowing 51 rotational DOF (51DOF) and corresponding models including seven sets of kinematic constraints that limited spine motion from 3 to 9DOF. Outcomes included: (1) root mean square (RMS) error of spine markers (measured vs. model); (2) lag-one autocorrelation coefficients to assess smoothness of angular motions; (3) maximum range of motion (ROM) of intervertebral joints in three directions of motion (FE, LB, AR) to assess whether they are physiologically reasonable; and (4) segmental spine angles in static ROM trials. We found that RMS error of spine markers was higher with constraints than without (p < 0.0001) but did not notably improve kinematic constraints above 6DOF. Compared to segmental angles calculated directly from spine markers, models with kinematic constraints had moderate to good intraclass correlation coefficients (ICCs) for flexion-extension and lateral bending, though weak to moderate ICCs for axial rotation. Adding more DOF to kinematic constraints did not improve performance in matching segmental angles. Kinematic constraints with 4-6DOF produced similar levels of smoothness across all tasks and generally improved smoothness compared to 9DOF or unconstrained (51DOF) models. Our results also revealed that the maximum joint ROMs predicted using 4-6DOF constraints were largely within physiologically acceptable ranges throughout the spine and in all directions of motions. We conclude that a kinematic constraint with 5DOF can produce smooth spine motions with physiologically reasonable joint ROMs and relatively low marker error.

SUBMITTER: Alemi MM

PROVIDER: S-EPMC8358679 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:A precise and comprehensive definition of "normal" in vivo cervical kinematics does not exist due to high intersubject variability and the absence of midrange kinematic data. In vitro test protocols and finite element models that are validated using only end range of motion data may not accurately reproduce continuous in vivo motion.The primary objective of this study was to precisely quantify cervical spine intervertebral kinematics during continuous, functional flexion-extension in asymptomatic subjects. The advantages of assessing continuous intervertebral kinematics were demonstrated by comparing asymptomatic controls with patients with single-level anterior arthrodesis.Cervical spine kinematics were determined during continuous in vivo flexion-extension in a clinically relevant age group of asymptomatic controls and a group of patients with C5-C6 arthrodesis.The patient sample consisted of 6 patients with single-level (C5-C6) anterior arthrodesis (average age: 48.8±6.9 years; 1 male, 5 female; 7.6±1.2 months postsurgery) and 18 asymptomatic control subjects of similar age (average age: 45.6±5.8 years; 5 male, 13 female).Outcome measures included the physiologic measure of continuous kinematic motion paths at each cervical motion segment (C2-C7) during flexion-extension.Participants performed flexion-extension while biplane radiographs were collected at 30 images per second. A previously validated tracking process determined three-dimensional vertebral positions with submillimeter accuracy. Continuous flexion-extension rotation and anterior-posterior translation motion paths were adjusted for disc height and static orientation of each corresponding motion segment.Intersubject variability in flexion-extension angle was decreased 15% to 46% and intersubject variability in anterior-posterior translation was reduced 14% to 33% after adjusting for disc height and static orientation angle. Average intersubject variability in continuous motion paths was 1.9° in flexion-extension and 0.6 mm in translation. Third-order polynomial equations were determined to precisely describe the continuous flexion-extension and anterior-posterior translation motion path at each motion segment (all R2>0.99).A significant portion of the intersubject variability in cervical kinematics can be explained by the disc height and the static orientation of each motion segment. Clinically relevant information may be gained by assessing intervertebral kinematics during continuous functional movement rather than at static, end range of motion positions. The fidelity of in vitro cervical spine mechanical testing protocols may be evaluated by comparing in vitro kinematics to the continuous motion paths presented.

Project description:This study aimed to provide a preliminary description of the sagittal and transverse plane kinematics of the thoracolumbar spine of Mangalarga Marchador (MM) horses performing the marcha batida gait, led in-hand. We evaluated the pattern of angular movement and the mean amplitude of six specific angles. An optoelectronic system was used for 3D kinematic analysis (19 cameras, 250 Hz). They were positioned around the horses and an acquisition volume of 16 × 4.8 × 3 meters was used. Eight retroreflective markers were fixed on the spine of the animals over thoracic vertebrae 8 (T8), 12 (T12), 15 (T15) and 18 (T18); over the lumbar vertebrae 3 (L3) and 5 (L5); over the 1st sacral vertebra (S1); and over the 1st coccygeal vertebra (CD1). Five trials, led from a halter, with three complete gait cycles were evaluated for each marcha batida horse. The 3D coordinates of the markers were filtered with a second-order, low-pass, Butterworth filter (10 Hz). Six angles: T8-T12-T15, T12-T15-T18, T12-T18-L5, T15-T18-L3, T18-L3-L5, and L3-S1-CD1 were obtained and projected in the sagittal (Flexion and Extension) and transverse (Lateral bending) planes. We calculated, for each angle to represent the spine movements, the mean and standard deviation of the range of motion (ROM, difference between the maximum and minimum values in a stride cycle). In order to describe the movement over an average stride cycle we calculated the mean curve of angle variation. The T8-T12-T15 angle presented the largest ROM in the transverse plane, while in the sagittal plane the T8-T12-T15, T12-T15-T18 and T12-T18-L5 angles presented the largest ROMs. The L3-S1-CD1 angle (lumbosacral region) presented the lowest ROM in both planes. A reduced flexion close to a neutral spine was found, predominantly during the diagonal support and in the cranial thoracic region. At the same time, the thoracolumbar region remains in an extension which is highlighted in the lumbosacral region. During the change of the support phase, the cranial thoracic region moved from a flexion to a slight extent, and the thoracolumbar region was flexed which is emphasized in the lumbosacral region. The lateral bending of the spine followed the direction of the diagonal supports. The small amplitude in the latero-lateral and dorsoventral movements of the thoracolumbar spine of MM horses during the marcha batida gait could contribute to the smooth and natural sensations experienced when riding in this gait. The lower mobility of these angles should be considered during the clinical examination of marcha batida-gaited horses.

Project description:PurposeMany minimally invasive surgical (MIS) techniques have been developed for instrumentation of spine. These MIS techniques restore stability, alignment while achieving return to function quite early as compared to open spine surgeries. The main aim of this review was to evaluate role, indications and complications of these MIS techniques in Thoracolumbar and Lumbar fractures.MethodsPubmed search using key words such as"Percutaneous pedicle screw for Thoracolumbar fractures" and "Video Assisted Thoracoscopy, Thoracoscopic, VATS for thoracolumbar, Lumbar and Spine fractures" were used till July 2016 while doing literature search. Authors analyzed all the articles, which came after search; the articles relevant to the topic were selected and used for the study. Both prospective and retrospective case control studies and randomized control trials (RCT's) were included in this review. Case reports and reviews were excluded. Studies demonstrating use of MIS in cases other than spine trauma and studies with lack of clinical follow up were excluded from this review. Variables such as number of patients, operative time and complications were evaluated in each study.ResultsAfter pubmed search, we found total 68 studies till July 2016 out of which eight studies were relevant for analysis of Video Assisted Thoracoscopy for thoracolumbar and lumbar fractures. Total 72 articles for Percutaneous pedicle screws in thoracolumbar and lumbar fractures were retrieved out of which percutaneous pedicle screws were analyzed in eleven studies and twelve studies involved comparison of percutaneous pedicle screws and conventional open techniques.ConclusionRole and Indications of the MIS techniques in spinal trauma are expanding quite rapidly. MIS techniques restore stability, alignment while achieving early return to function and lower infection rates as compared to open spine surgeries. In long term, they provide good kyphosis correction and stable fixation and fusion of spine. They are associated with long learning curve and technical challenges but with careful patient selection and in expert hands, MIS techniques may produce better results than open trauma spine surgeries.

Project description:ObjectiveThe aim of this study was to measure the movement of the cervical spine in healthy volunteers and patients with cervical spondylosis (CS) and describe the actual motion of the cervical spine using a three-dimensional (3D) CT reconstruction method. The results can enrich current biomechanical data of cervical spine and help to find the differences between the noted two groups.Materials and methods20 healthy volunteers underwent CT examination ranging from the clivus of the occiput (Oc) to the top of first thoracic vertebrae (T1) in a neutral position with left or right maximal axial rotation, while 26 CS patients received the same CT scan procedures in the neutral position with left and right maximum rotation. Subsequently, the three-dimensional images of the occiput and every cervical vertebrae (C1-C7) were reconstructed using medical software. 3 virtual non-collinear markers were placed on the prominent structures of foramen magnum and every cervical vertebrae. Then, the 3D orthogonal spatial coordinates were defined with these anatomical markers to represent the orientation and position of every vertebra. Segmental relative motions were calculated using Cardan angles in the 3D spatial coordinates. Finally, the differences between the two groups were analyzed with statistical software SPSS.ResultsThe cervical spine exhibited complicated 3D movements, which could be adequately described using the three-dimensional CT reconstruction method. Reliability analysis of the 3D CT reconstruction method showed inter-rater ICC of 0.90-0.99 and intra-rater ICC of 0.91-0.98, suggesting very good consistency. Besides, the rotation at the upper cervical spine (Oc-C2) took up at least 60% of the total cervical rotation. The coupled lateral bending movement of the upper cervical spine was opposite to the major motion, while the movement of the lower cervical spine followed the same direction as that of the major motion. Oc to C5 segments were all coupled with the back-extension movement. The relative translations of all adjacent segments in each direction were minimal. CS patients showed a significant decrease in the movement of the C4-C5 segment compared with healthy volunteers.ConclusionThe motion of the cervical spine was complicated and three-dimensional. The CT reconstruction method employed here was good at describing such movement. The 3D CT reconstruction method exhibited high reproducibility when measuring cervical spine movement. CS patients and healthy volunteers showed significant differences in the movement of some segments.

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The Influence of Kinematic Constraints on Model Performance During Inverse Kinematics Analysis of the Thoracolumbar Spine.

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