Researchers at Hospital for Special Surgery (HSS) in New York City are enrolling patients in a study using cutting-edge imaging technology to produce three-dimensional maps of the spine in people with scoliosis.
Currently, physicians monitor patients with scoliosis — an excessive curvature of the spine — using x-rays for a period of many years. This extensive exposure to radiation can be harmful, particularly as scoliosis primarily affects young people. HSS researchers hope the results of the study will lead to an algorithm to estimate the curvature of the spine without the need for x-rays.
At the heart of the approach is a highly accurate 30 camera whole body 3D surface imaging system manufactured by 3dMD, which acquires the patients shape using stereophotogrammetry. “You can take that image, flip it upside down, slice it and dice it at any level that you want because it’s a mathematical depiction of the surface of the patient,” said Roger F. Widmann, MD, Chief of the Pediatric Orthopedic Surgery Service at HSS.
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“This technology is essentially producing the world’s most advanced selfie, and the benefit is that there’s nothing dangerous about it,” said Howard J. Hillstrom, PhD, director of the Leon Root, MD Motion Analysis Laboratory at HSS and the principal investigator of the study. “When you image with this system, you can count the number of hairs on a person’s leg.”
The new study combines two recently available imaging technologies: topographical mapping using 3dMD, a proprietary system of high-resolution cameras, and EOS imaging, a dual plane x-ray machine that determines spinal alignment while significantly reducing exposure to ionizing radiation. The 3dMD system combines information from 30 high-definition cameras to produce a full map of the torso in under a second. The speed of the process is a significant advantage over conventional imaging, according to Dr. Hillstrom, who noted that up to 10 to 20 percent of torso x-rays must be redone because inadvertent movements during the scans distort the picture. “3dMD is immune to that,” he said. In conjunction with collaborators from Technion (Alon Wolf, PhD, Ron Kimmel, PhD, and Benjamin Groisser), a leading scientific university in Israel, it is the long-term goal for HSS to improve the ability of estimating spinal malalignment with a minimum amount of radiation exposure to these patients.
Scoliosis affects an estimated 6 to 9 million Americans, or roughly 2 to 3% of the population; most patients are female. The condition typically is detected when children are in elementary school, during routine screening at school or at their pediatrician’s office. If scoliosis is suspected, clinicians will try to determine the extent of the curvature — mild, moderate or severe — using x-rays. Although mild and moderate cases can improve with physical therapy and bracing, severe cases may require surgery. “Severe scoliosis starts to affect the symmetry of the thoracic cavity and might then affect lung function,” Dr. Hillstrom said.