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I was delighted to present the latest results of a major study into the diagnosis of idiopathic scoliosis at ScoSym, the first international symposium on current trends in research on scoliosis and other spinal deformities. Speaking to 200 delegates from 19 countries in Novi Sad, Serbia, in June, the findings came from a collaborative research study, which started in 2017.
Working with Professor Nachiappan Chockalingam of the Centre for Biomechanics and Rehabilitation Technologies at Staffordshire University, and Nikola Jevtic, Director of the Scolio Centar in Novi Sad, we have been developing innovative new ways to use low-cost and readily available technologies, to improve the quality of life of children and adolescent patients diagnosed with a curvature of the spine of unknown causation. Whilst in Novi Sad, Nachi and I also visited Nikola’s clinic to carry out patient measurements, which will be combined with similar programs in Belgrade, Romania and Bulgaria.
The first indications of idiopathic scoliosis, which sees the spine simultaneously rotating and curving towards the arms, are often changes in body symmetry and back surface shape. It can force the ribs outwards, causing a hump in the back, a distinctive characteristic of a scoliotic curve in the upper spine, which can cause significant distress in affected patients. For many adolescent patients, the motivation for seeking treatment is to improve their appearance, rather than to correct or stabilize an underlying skeletal deformity.
When it comes to the clinical decision-making process, cosmetic concerns, quality of life and psychosocial impacts on patients are extremely important factors to consider. In recent years, research has shown that the addition of validated body asymmetry metrics, alongside conventional radiologically derived measures, could be extremely beneficial when designing a patient-specific treatment plan and quantifying outcomes.
In 2014, Microsoft® launched a low-cost range-imaging camera as a component of their commercial games machine offerings, designed using a Time-of-Flight technique. The principle behind the device was to derive the distance and time travelled between an emitter, objects in a scene, and a receiver, using the speed of light. Independent researchers have subsequently published findings, which show that depth measurement errors were acceptable in clinical application. Bespoke software code, based on contemporary computer vision algorithms, has since been developed, which can use the captured point clouds to generate measures and imagery that may be valuable in the assessment and monitoring of back shape cosmetic defects of AIS patients.
Nachi, Nikola and I wanted to better understand how the surface measurement applications, like those used by Microsoft®, could be applied clinically to assess patients showing indications of idiopathic scoliosis. After obtaining the necessary ethical approvals, we investigated the back symmetry of a group of 23 skeletally-mature subjects not exhibiting any musculoskeletal disease, to ensure the apparatus did not introduce any bias, and 32 adolescents attending Schroth exercise clinics in Serbia and Bulgaria.
The primary objective of the study was to investigate the relationship between each patient’s radiological measures, curve type, and the team’s latest metrics. The results also demonstrated a higher presence of cosmetic deformity in the back surface topographic measures amongst the patients attending Schroth exercise clinics, compared to the findings from a typically developed adolescent group.
The study has provided the confidence needed to continue our research into how these surface measures can be applied clinically, as an additional resource to existing radiological and physical assessments. We also plan to design further structured studies to establish if our algorithms can contribute to quantifying the back shape of patients routinely presenting at scoliosis clinics across the world.
ScoSym was a tremendous opportunity to share new insights and discuss new challenges with experts in research into spinal deformities across the world. We hope our continued studies will help to meet those challenges and bring more rapid and affordable assessment and diagnosis for patients, to improve their quality of life.
-Dr. Tom Shannon has over 35 years’ international experience as a practicing biomedical engineer, medical physicist and computer vision scientist.
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