Robustness of Whole Spine Reconstruction using Anterior-Posterior and Lateral Planar X-ray Images

Abstract

The X-ray-based reconstruction methods using anterior-posterior (AP) and lateral (LAT) images assumes that the angle between the AP and LAT images is perpendicular. However, it is difficult to maintain the perfect perpendicular angle between the AP and LAT images when taking those two images sequentially in real situations. In this study, the robustness of a three-dimensional (3D) whole spine reconstruction method using AP and LAT planar X-ray images was analyzed by investigating cases in which the AP and LAT images were not taken perpendicularly. 3D models of the patient-specific spine from five subjects were reconstructed using AP and LAT X-Ray images and the 3D template models of C1 to L5 vertebrae based on B-spline free-form deformation (FFD) technology. The shape error, projected area error, and relative error in length were quantified by comparing the reconstructed model (FFD model) to the reference model (CT model). The results indicated that the reconstruction method might be considered robust in case that there is a small angular error, such as 5°, between the AP and LAT images. This study suggested that simple technical indications to obtain the perpendicular AP and LAT images in real situations can improve accuracy of 3D spine reconstruction.