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Novo método de caracterização 3D da escoliose idiopática do adolescente
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Advisor(s)
Abstract(s)
A existência de condições e patologias associadas à coluna vertebral desperta atenção,
uma vez que a coluna é crucial na saúde e bem-estar, assim como na manutenção da postura.
Entre várias condições existentes, a escoliose é uma patologia caracterizada pela alteração da
curvatura natural da coluna vertebral, onde a mesma padeceu de rotação no plano axial, coronal
e no plano sagital. É uma deformação tridimensional e é caracterizada como escoliose quando
apresenta discrepância de 10º de amplitude da curva. Esta condição deve ser diagnosticada e
classificada durante o período da adolescência, enquanto existe crescimento ósseo. Existem
vários métodos para diagnosticar e classificar a curvatura da escoliose, assim como existem
igualmente, várias abordagens para o tratamento. Um dos tratamentos inovadores e
relativamente recente, é a técnica cirúrgica Vertebral Pedicular Tethering. Esta técnica coloca
parafusos na zona posterior da vértebra e sendo uma técnica recente, existem algumas questões
a nível da caracterização desta patologia que ainda não estão respondidas.
Este trabalho focou-se na quantificação de vértebras através do desenvolvimento de uma
metodologia para dar resposta e melhorar a nova técnica mencionada. Esta metodologia
desenvolvida teve como base a extração de centroides de cada vértebra e a interseção dos
mesmos com planos que ditam a posição dos respetivos eixos de cada componente. Este
conjunto de elementos permitiu estudar a posição e a variação de cada vértebra, auxiliando no
processo computacional. Os principais resultados são a perceção de desvio que ocorreu, em 3D,
tanto no desvio angular, rotação dentro da própria coluna e rotação dentro de cada vértebra
individual.
A avaliação comparativa entre o 2D e o 3D, assim como o método CT face aos exames
convencionalmente realizados mostraram diferenças significativas dando mais qualidade à
quantificação quando utilizada a metodologia 3D de CT. Findando com as limitações e
perspetivas futuras que promovem trabalhos seguintes, porém o foco mantém-se na
automatização da metodologia desenvolvida e abordada ao longo deste trabalho para melhor
conhecimento do comportamento de colunas com escoliose de variados graus de classificação.
The existence of conditions and pathologies associated with the spine attracts attention, since the spine is crucial for health and well-being, as well as for maintaining posture. Among the various existing conditions, scoliosis is a pathology characterized by an alteration in the natural curvature of the spine, where it suffers from rotation in the axial, coronal, and sagittal planes. It is a three-dimensional deformation and is characterized as scoliosis when there is a discrepancy of 10º in the amplitude of the curve. This condition should be diagnosed and classified during adolescence, while there is bone growth. There are various methods for diagnosing and classifying the curvature of scoliosis, as well as various approaches to treatment. One innovative and recent treatment is the Vertebral Pedicle Tethering surgical technique. This technique places screws in the posterior area of the vertebra and, as it is a recent technique, there are still unanswered questions regarding the characterization of this pathology. This work focused on the quantification of vertebra by developing a methodology to respond to and improve the new technique mentioned above. The methodology developed was based on the extraction of centroids from each vertebra and their intersection with planes that determine the position of the respective axes of each component. This element made it possible to study the position and variation of each vertebra, aiding the computational process. The main results are the perception of deviation that occurred, in 3D, both in angular deviation, rotation within the spine itself and rotation within each individual vertebra. The comparative evaluation between 2D and 3D, as well as the CT method compared to conventionally performed exams, showed significant differences, giving a higher quality of quantification when using the 3D CT methodology. This concludes with limitations and future perspectives that promote further work, but the focus remains on automating the methodology developed and addressed throughout this work to better understand the behavior of columns with scoliosis of varying degrees of classification.
The existence of conditions and pathologies associated with the spine attracts attention, since the spine is crucial for health and well-being, as well as for maintaining posture. Among the various existing conditions, scoliosis is a pathology characterized by an alteration in the natural curvature of the spine, where it suffers from rotation in the axial, coronal, and sagittal planes. It is a three-dimensional deformation and is characterized as scoliosis when there is a discrepancy of 10º in the amplitude of the curve. This condition should be diagnosed and classified during adolescence, while there is bone growth. There are various methods for diagnosing and classifying the curvature of scoliosis, as well as various approaches to treatment. One innovative and recent treatment is the Vertebral Pedicle Tethering surgical technique. This technique places screws in the posterior area of the vertebra and, as it is a recent technique, there are still unanswered questions regarding the characterization of this pathology. This work focused on the quantification of vertebra by developing a methodology to respond to and improve the new technique mentioned above. The methodology developed was based on the extraction of centroids from each vertebra and their intersection with planes that determine the position of the respective axes of each component. This element made it possible to study the position and variation of each vertebra, aiding the computational process. The main results are the perception of deviation that occurred, in 3D, both in angular deviation, rotation within the spine itself and rotation within each individual vertebra. The comparative evaluation between 2D and 3D, as well as the CT method compared to conventionally performed exams, showed significant differences, giving a higher quality of quantification when using the 3D CT methodology. This concludes with limitations and future perspectives that promote further work, but the focus remains on automating the methodology developed and addressed throughout this work to better understand the behavior of columns with scoliosis of varying degrees of classification.
Description
Keywords
Coluna vertebral Escoliose Ângulos de rotação Quantificação Ângulo de Cobb Spine Scoliosis Rotation angle Quantification Cobb angle