Assessment Of Lumbar Lordosis Research Articles

Deep Learning based Vertebral Body Segmentation with Extraction of Spinal Measurements and Disorder Disease Classification

Assessment of medical images and diagnostic decision making of lumbar associated diseases by clinicians is invariably subjective, time consuming and challenging task. Presently, clinicians make use of either manual or semi-automated computer-aided tools to make relevant measurements for adding vote of confidence to their grading and evaluation. Lacking reliability and offering substantive dissimilarity once performed by different clinicians, these methods complicate the evaluation process. In an effort to support the decision making process of clinicians, in this paper we present a lumbar assessment framework with autonomous extraction of spinal measurements. Furthermore, an effort is made to address the challenges faced by clinicians while assessing disorders including spondylolisthesis and assessment of lumbar lordosis (LL) by proposing novel disease classification methodologies. For spondylolisthesis classification, we achieved an accuracy of 89% by using angular deviation metric whereas, 93% accuracy for determining adequacy/inadequacy in LL assessment through computation of area within enclosed lumbar curve region. Our framework involves semantic segmentation of vertebral bodies (VBs) using ResNet-UNet where we achieved DSC of 0.97 and IoU of 0.86. Subsequently, we achieved a statistically significant correlation coefficient R and encouraging mean absolute error (MAE) with clinicians’ grading for measurements involving lumbar lordotic angle (LLA), lumbosacral angle (LSA), VB dimensions and lumbar height. In addition to this, we have publicly released the dataset with all the clinicians markings athttps://data.mendeley.com/datasets/k3b363f3vz/2.

196. Longitudinal changes of the sagittal plane after posterior spinal fusion of adolescent idiopathic scoliosis in Lenke 5 and 6 from baseline to two-year follow-up

BACKGROUND CONTEXT The coronal plane in adolescent idiopathic scoliosis (AIS) has been extensively studied. However, studies investigating the changes in sagittal parameters before and after posterior spinal fusion in Lenke types 5 and 6 are scarce. Sagittal plane assessment of lumbar lordosis (LL), pelvic tilt (PT) and pelvic incidence (PI) in AIS Lenke 5 & 6 has not been fully delineated. PURPOSE The purpose of this study was to report on the spinopelvic parameters over 2 years. AIS Lenke 5 & 6 pts who underwent PSF were stratified into 3 groups based on amount of preop lumbar lordosis (low LL 60). Sagittal plane and spinopelvic parameters were followed longitudinally over 2 years postop. STUDY DESIGN/SETTING This study was a retrospective review of a prospectively collected multicenter database of patients with AIS who underwent spinal fusion. PATIENT SAMPLE Multicenter database of AIS patients, Lenke 5 and 6, who underwent PSF with 2-year follow-up and radiographic data were included. OUTCOME MEASURES Radiographic spinopelvic parameters including lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and thoracolumbar kyphosis (TL kyphosis). METHODS Baseline, 6-week, 6-month, 1-year and 2-year follow-up radiographs were analyzed for sagittal plane parameters (LL, PI, PT and TL kyphosis). Lenke 5 & 6 pts were stratified according to LL into 3 groups; low LL 60. Patients within each LL group were followed from preop to 2 years after PSF for changes in TL kyphosis, LL, PI and PT. RESULTS A total of 242 Lenke 5 (L5) and 223 Lenke 6 (L6) patients were studied. In the L5 pts, the average preop LL was −56 (−24 to −93), average preop PT was 9.3 (−10-26). In L5 pts with preop LL 60 (n=94), postop LL increased to 6 months then plateaued while PT trended down from 6 weeks to 2 years. L6 patients had an average preop LL of-55 (−21 to −91), average preop PT 10(−6 to 52). L6 pts with preop LL 60 (n= 71) LL increased from 6 weeks to 6 months back to preop value and remained unchanged at 2 yrs. PI did not change over time but lumbar lordosis increased over the 2 years. CONCLUSIONS There is an inverse relationship between LL and PT in patients with Lenke types 5&6 when longitudinally tracked over 2 years postoperatively. PI did not change but lumbar lordosis increased over 2 years. When lumbar lordosis increases, sagittal plane adapts to PSF and improves over time. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Non-invasive postural assessment of the spine in the sagittal plane: a systematic review

<p>The objective of this review was to examine the scientific evidence regarding the aspects of validation in non-invasive methods of assessing the spine in the sagittal plane. A systematic search was conducted in following data bases Scopus, Science Direct, PubMed and Medline<em>. </em>To be included the papers must have: conducted a non-invasive assessment of thoracic kyphosis and/or lumbar lordosis; evaluated at least one aspect of validity; been written in English; and been published in the previously three decades. Papers that score less than three in the QUADAS scale were excluded. Initially, 70 articles were pre-selected. Of this, 52 were finally included as they met the quality criterion. Based on this review, the following techniques/instruments were found to present satisfactory results for all aspects of validity in the assessment of thoracic kyphosis: photogrammetry, flexible ruler, archometer, and DeBrunner’skyphometer. Similarly, photogrammetry, inclinometer, flexible ruler, archometer and kypholordometer were found to present satisfactory results in the assessment of lumbar lordosis. Therefore, it is suggested that these instruments be adopted as first choice for evaluating the spine in the sagittal plane, since they present adequate reproducibility and concurrent validity.</p><p><br /><strong></strong></p>

Assessment of Lumbar Lordosis and Lumbar Core Strength in Information Technology Professionals.

Study DesignObservational study.PurposeTo correlate lumbar lordosis and lumbar core strength in information technology (IT) professionals.Overview of LiteratureIT professionals have to work for long hours in a sitting position, which can affect lumbar lordosis and lumbar core strength.MethodsFlexicurve was used to assess the lumbar lordosis, and pressure biofeedback was used to assess the lumbar core strength in the IT professionals. All subjects, both male and female, with and without complaint of low back pain and working for two or more years were included, and subjects with a history of spinal surgery or spinal deformity were excluded from the study. Analysis was done using Pearson's correlation.ResultsFor the IT workers, no correlation was seen between lumbar lordosis and lumbar core strength (r=–0.04); however, a weak negative correlation was seen in IT people who complained of pain (r=–0.12), while there was no correlation of lumbar lordosis and lumbar core in IT people who had no complains of pain (r=0.007).ConclusionsThe study shows that there is no correlation of lumbar lordosis and lumbar core strength in IT professionals, but a weak negative correlation was seen in IT people who complained of pain.

Investigation of the Flexible Ruler as a Noninvasive Measure of Lumbar Lordosis in Black and White Adult Female Sample Populations

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Army, the Department of Defense, or the U.S. Government. The purpose of this study was to investigate the validity of the flexible ruler as a noninvasive measure of lumbar lordosis in black and white adult females. The bony landmarks of the second lumbar vertebra (L2) and the intersection of the posterior superior iliac spines (PSIS) were palpated and marked on 45 adult females (21 blacks, 24 whites). Potential subjects with a previous history of activity-limiting low-back pain, spinal surgery, or spinal anomaly were excluded from the study. A lateral lumbosacral roentgenograph was taken of each subject, and an actual (skeletal) lumbosacral lordosis angle (ALS) was calculated from the roentgenograph. A flexible ruler was then molded to the contour of the subject's lumbosacral spine, and the previously marked L2 and PSIS intersection bony landmarks were located on the flexible ruler. The flexible ruler lordosis angle (FRA) was then calculated and correlated to the subject's ALS. The criterion validity of the flexible ruler as a measure of actual lumbosacral lordosis was poor (Pearsons' Correlation Coefficient = 0.30, N = 45). Because of the poor criterion validity of the flexible ruler compared to roentgenographically confirmed lumbar lordosis, the flexible ruler has questionable clinical value in the assessment of lumbar lordosis. J Orthop Sports Phys Ther 1989;11(1):3-7.