Modeling Thoracic Volume To predict Pulmonary Function in Scoliosis

Slides:



Advertisements
Similar presentations
Minimally Invasive Pectus Excavatum Repair: The Nuss Procedure
Advertisements

MINIMIZE IMPLANTS, MAXIMIZE OUTCOMES
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Scoliosis.
Surgery of Spinal Deformities Rizzoli Orthopaedic Institute Bologna, Italy Surgical options in progressive scoliosis in pediatric patients with Neurofibromatosis.
Fusionless Correction for Early Onset Scoliosis (EOS) Emma Orton BME 281.
Which is breathing in and which is breathing out? AB.
Biomechanics of breathing. Lungs ventilation
Thoracogenic Spinal Deformity: A Rare Cause of Early Onset Scoliosis International Congress on Early Onset Scoliosis November 19 & 20, 2015 A. Noelle Larson,
Cincinnati Children’s Hospital Medical Center
©2015 MFMER | slide-1 How Does Patient Radiation Exposure Compare with Low Dose O-Arm vs. Fluoroscopy for Pedicle Screw Placement? a,b Alvin W. Su, MD,
Secondary Thoracic Insufficiency Syndrome in None Ambulatory Myelodisplastic Children.
Comparison of deformity correction and complications with VEPTR and early primary posterior spinal fusion in young children with idiopathic scoliosis:
Pulmonary Function Following Early Thoracic Fusion in Non-Neuromuscular Scoliosis by Lori A. Karol, Charles Johnston, Kiril Mladenov, Peter Schochet, Patricia.
Final Fusion in Patients Treated with Rib Based Distraction: A Review of Peri- operative Results THE UNIVERSITY OF UTAH Department of Orthopaedic Surgery.
Burt Yaszay, MD Jeff B. Pawelek, BS John Emans, MD Patrick Cahill, MD Bo Robertson Gregory M. Mundis, MD Behrooz A. Akbarnia, MD Children’s Spine Study.
Akash Gupta, R1.  16 y/o male seen in clinic with Dr. Meehan  Obvious deformity of R Chest Wall – cosmesis worsening over 2 years  Activities: Soccer.
Straightening the mast might not improve getting the wind in the sails Sean Haloman, R1.
Adult female with severe progressive scoliosis possibly secondary to benign tumor removal at age 3 treated with Scoliosis Specific Schroth Physiotherapy.
ICEOS 2016 Pelvic obliquity correction in distraction based growing spine constructs Mathew Schur BA1, Lindsay M Andras MD1, Nicholas R Gonsalves MD1,
ICEOS 2016 Comparison of Weight Percentile Gain with Growth-Friendly Constructs in Early Onset Scoliosis Liam Harris BS1, Lindsay M Andras MD1, Paul D.
Choosing Wisely : Radiology Perspective
The surgical treatment aims to:
Outcomes of Children with Jarcho-Levin Syndrome treated with a Vertebral Expandable Prosthetic Titanium Rib (VEPTR) Frances A. Farley, MD, Michelle C.
Early Treatment of Scoliosis in Spinal Muscular Atrophy
John T. Smith, MD Jessica V. Morgan John A. Heflin, MD
EOS Patients from A Retrospective database
Clinical correlation of SRS-Schwab Classification with HRQOL measures in a prospective non-US cohort of ASD patients Dennis H. Nielsen, MD; Lars V. Hansen,
UNC Department of Surgery Grand Rounds
Ju Mei, Guoqing Li, Zhaolei Jiang, Fangbao Ding
Scoliosis Idiopathic Scoliosis In Adolescents NEJM Feb 28, 2013: 368:9
Left Thoracotomy: An Ideal Approach for Mitral Valve Replacement in Patient With Severe Chest Wall Deformity  Juan G. Bastidas, MD, Anees J. Razzouk,
Richard Schwend, MD Robert Tung, BS Division of Orthopedic Surgery
Lobar lung transplantation: One size fits all
Large-Volume Thoracentesis and the Risk of Reexpansion Pulmonary Edema
Distraction-Based Surgeries Increase Spine Length for Patients with Non-Idiopathic EOS - 5 Year Follow up Yehia ElBromboly, Jennifer Hurry, Kedar Padhye,
Existing General Population Models Inaccurately Predict Lung Cancer Risk in Patients Referred for Surgical Evaluation  James M. Isbell, MD, MSCI, Stephen.
Stress distribution on the thorax after the Nuss procedure for pectus excavatum results in different patterns between adult and child patients  Tomohisa.
Restrictive Chest Wall Deformity as a Complication of Surgical Repair for Pectus Excavatum  Chih-Hao Chen, MD, Hung-Chang Liu, MD, Tzu-Ti Hung, BN, Chao-Hung.
Syncope caused by right ventricular obstruction by pectus excavatum
Does rod orientation and use of cross connector affect spinal height in magnetically controlled growing rod patients? Pooria Hosseini, Behrooz A. Akbarnia,
Definition of postoperative bleeding in children undergoing cardiac surgery with cardiopulmonary bypass: One size doesn't fit all  David Faraoni, MD,
Evaluation of Pulse Oximetry in Pre- and Post Casting
Clinical Process Cost Analysis
Magnetically Controlled Growing Rods: Sagittal Plane Analysis and the Risk of Proximal Junctional Kyphosis Purnendu Gupta, Felix Brassard, Jennifer Schottler,
Predictive equations for lung volumes from computed tomography for size matching in pulmonary transplantation  Jeremy A. Konheim, MD, Zachary N. Kon,
Hernia of the lung The Annals of Thoracic Surgery
Can FDG-PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer?  Kemp H Kernstine, MD, PhD, Kelley A McLaughlin,
Scalenus Anticus Syndrome — A Late Sequela of Thoracoplasty
Top 3 Articles That Changed My Approach to EOS
Şevval Eren, MD, Mehmet Nesimi Eren, MD, Akin Eraslan Balcı, MD 
Glen Ginsburg, M.D. ∆ Richard M. Schwend, M.D. ∫ John Schmidt, PhD Φ
Case discussions ICEOS 2009 Istanbul Jack Flynn, MD
Outcome Measures in Early Onset Scoliosis
Quality of Life Outcomes in Early Onset Scoliosis
Imaging in Early Onset Scoliosis
Charles E. Johnston, MD Anna McClung BSN, RN Scott Paradise
Dual Rods and Submuscular Rod Placement Reduce Complications and Unplanned Surgeries in the Growing Spine: Analysis of 910 Surgeries in 143 Patients Shay.
Greg Redding, MD Professor of Pediatrics
John A Heflin, MD John T. Smith, MD
Long-term results in surgical management of congenital scoliosis (CS): A minimum 10 years follow-up study Debnath UK Harshavardhana NS Hegarty J Grevitt.
Classification of EOS Treatment
Klane K. White, MD, MSc Viviana Bompadre, PhD Adam J. Kreutzer
Reliability analysis for Cobb angle measurements of congenital scoliosis using X ray and 3D-CT Ryoji Tauchi1), Taichi Tsuji2) , Toshiki Saito2) , Ayato.
Pulmonary Outcomes after VEPTR Intervention
Nicholas D. Fletcher, MD¹ Charles E. Johnston III, MD²
ICEOS 2009, Istanbul Natural History of Spine in Patients with Esophageal Atresia -A Long-Term Population-Based Follow-up Study Ilkka Helenius, Saara J.
ICEOS 2013 At What Levels Are Free-Hand Pedicle Screws More Frequently Malpositioned in Children? Mark Heidenreich, BS Yaser M.K. Baghdadi, MD Amy L. McIntosh,
Amer F. Samdani, MD Tricia St. Hilaire John Emans, MD John Smith, MD
J. Clin PhD, C.E. Aubin Ph.D., P.Eng. S. Parent MD, PhD
ARTHROGRYPOSIS AND VEPTR
Presentation transcript:

Modeling Thoracic Volume To predict Pulmonary Function in Scoliosis David Polly Jr. MD1,Benjamin Rosenstein2, Charles Ledonio, MD1, A. Noelle Larson, MD3, and David J Nuckley, PhD2 1Department of Orthopaedic Surgery and 2Department of Physical Medicine and Rehabilitation; University of Minnesota, Minneapolis, MN. 3Mayo Clinic, Rochester, MN.

Disclosures The authors have no financial disclosures Presenter: David W. Polly, Jr., MD (a) SRS, POSNA, SRF, OREF, DOD (b) Medtronic Spine & Navigation ended 10/1/09 & 6/28/10 Co-Authors: Benjamin E. Rosenstein No relationship Charles Gerald T. Ledonio, MD (a) SRS, POSNA, SRF, OREF, DOD, Medtronic A. Noelle Larson, MD (a) SRS, POSNA, OREF David J. Nuckley, PhD (a) Medtronic Grants/Research Support Consultant Stock/Shareholder Speakers’ Bureau Other Financial Support

Background While moderate scoliosis is present in 1 in 300 children its effects on pulmonary compromise is not well understood. Scoliosis deformity has long been linked with deleterious effects on pulmonary function. The causal relationship between spine/chest wall deformity and pulmonary function has yet to be fully defined. It has been hypothesized that deformity correction improves pulmonary function by restoring both respiratory muscle efficiency and increasing the space available to the lungs.

Objective The objective of this research was to develop and validate a computational model to measure thoracic volume for scoliosis, pectus excavatum and combined deformity in order to predict cardiopulmonary function.

Methods Utilizing Blender software we constructed a computational model of the spine and thorax which may be ‘computationally deformed’ to match chest X-rays and compute the resulting thoracic volume Size and orientation of the individual bones of the spine and thorax are altered until they fit the x-ray projections of the patient, creating a patient-specific model. Thoracic volume was then computed by meshing the space within the thoracic cavity.

Thoracic Volume Modeling The initial model is placed in a virtual x-ray where calibrated patient x-rays are placed orthogonal within the space. An x-ray projection of the 3D torso is overlayed on the x-rays and the bones are then deformed to match the x-rays.

Thoracic Volume Modeling The deformed spine and ribs are projected in the virtual x-ray to evaluate how well they match the patient films.

Thoracic Volume Modeling After deforming the spine and ribs and altering their orientation, the thoracic volume was computed above the diaphragm.

METHODS Model development was performed using 4 healthy adult CTs of the thorax and then tested on eight scoliosis cases for model validity. The thoracic volumes measured for the scoliosis cases were on average 8.4 cm3 different between the methods with a maximum error of 3.8% and a mean error of 2.4%.

Correlation of PFTs with Volume AIS Patients with the Pre-Surgical Lowest PFT Values

Conclusion We have developed a methodology for deforming a computational model to create a patient-specific skeletal thorax which can be used to measure thoracic volume. This model has been validated using scoliosis cases to reveal a maximal error of 3.8%. Using this model we aim to apply it to different types and severities of scoliosis and combined deformity patients to develop a prediction model wherein thoracic volume and functional outcomes may be predicted based upon the type and severity of deformity. Also see e poster 11 Thanks!