Scoliosis Follow-Up Using Noninvasive Trunk Surface Acquisition

Adolescent idiopathic scoliosis (AIS) is a musculoskeletal pathology. It is a complex spinal curvature in a 3-D space that also affects the appearance of the trunk. The clinical follow-up of AIS is decisive for its management. Currently, the Cobb angle, which is measured from full spine radiography, is the most common indicator of the scoliosis progression. However, cumulative exposure to X-rays radiation increases the risk for certain cancers. Thus, a noninvasive method for the identification of the scoliosis progression from trunk shape analysis would be helpful. In this study, a statistical model is built from a set of healthy subjects using independent component analysis and genetic algorithm. Based on this model, a representation of each scoliotic trunk from a set of AIS patients is computed and the difference between two successive acquisitions is used to determine if the scoliosis has progressed or not. This study was conducted on 58 subjects comprising 28 healthy subjects and 30 AIS patients who had trunk surface acquisitions in upright standing posture. The model detects 93% of the progressive cases and 80% of the nonprogressive cases. Thus, the rate of false negatives, representing the proportion of undetected progressions, is very low, only 7%. This study shows that it is possible to perform a scoliotic patient's follow-up using 3-D trunk image analysis, which is based on a noninvasive acquisition technique.

Analysis of scoliosis trunk deformities using ICA

This paper describes a method for analyzing scoliosis trunk deformities using Independent Component Analysis (ICA). Our hypothesis is that ICA can capture the scoliosis deformities visible on the trunk. Unlike Principal Component Analysis (PCA), ICA gives local shape variation and assumes that the data distribution is not normal. 3D torso images of 56 subjects including 28 patients with adolescent idiopathic scoliosis and 28 healthy subjects are analyzed using ICA. First, we remark that the independent components capture the local scoliosis deformities as the shoulder variation, the scapula asymmetry and the waist deformation. Second, we note that the different scoliosis curve types are characterized by different combinations of specific independent components.

A physically based trunk soft tissue modeling for scoliosis surgery planning systems

One of the major concerns of scoliotic patients undergoing spinal correction surgery is the trunk's external appearance after the surgery. This paper presents a novel incremental approach for simulating postoperative trunk shape in scoliosis surgery. Preoperative and postoperative trunk shapes data were obtained using three-dimensional medical imaging techniques for seven patients with adolescent idiopathic scoliosis. Results of qualitative and quantitative evaluations, based on the comparison of the simulated and actual postoperative trunk surfaces, showed an adequate accuracy of the method. Our approach provides a candidate simulation tool to be used in a clinical environment for the surgery planning process.

Simulation of the postoperative trunk appearance in scoliosis surgery

Persistence of external trunk asymmetry after scoliosis surgical treatment is frequent and difficult to predict by clinicians. This is a significant problem considering that correction of the apparent deformity is a major factor of satisfaction for the patients. A simulation of the correction on the external appearance would allow the clinician to illustrate to the patient the potential result of the surgery and would help in deciding on a surgical strategy that could most improve his/her appearance. We describe a method to predict the scoliotic trunk shape after a spine surgical intervention. The capability of our method was evaluated using real data of scoliotic patients. Results of the qualitative evaluation were very promising and a quantitative evaluation based on the comparison of the simulated and the actual postoperative trunk surface showed an adequate accuracy for clinical assessment. The required short simulation time also makes our approach an eligible candidate for a clinical environment demanding interactive simulations.

Validity of a Quantitative Clinical Measurement Tool of Trunk Posture in Idiopathic Scoliosis

STUDY DESIGN: Concurrent validity between postural indices obtained from digital photographs (two-dimensional [2D]), surface topography imaging (three-dimensional [3D]), and radiographs. OBJECTIVE: To assess the validity of a quantitative clinical postural assessment tool of the trunk based on photographs (2D) as compared to a surface topography system (3D) as well as indices calculated from radiographs. SUMMARY OF BACKGROUND DATA: To monitor progression of scoliosis or change in posture over time in young persons with idiopathic scoliosis (IS), noninvasive and nonionizing methods are recommended. In a clinical setting, posture can be quite easily assessed by calculating key postural indices from photographs. METHODS: Quantitative postural indices of 70 subjects aged 10 to 20 years old with IS (Cobb angle, 15 degrees -60 degrees) were measured from photographs and from 3D trunk surface images taken in the standing position. Shoulder, scapula, trunk list, pelvis, scoliosis, and waist angles indices were calculated with specially designed software. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The Pearson correlation coefficients (r) was used to estimate concurrent validity of the 2D clinical postural tool of the trunk with indices extracted from the 3D system and with those obtained from radiographs. RESULTS: The correlation between 2D and 3D indices was good to excellent for shoulder, pelvis, trunk list, and thoracic scoliosis (0.81>r<0.97; P<0.01) but fair to moderate for thoracic kyphosis, lumbar lordosis, and thoracolumbar or lumbar scoliosis (0.30>r<0.56; P<0.05). The correlation between 2D and radiograph spinal indices was fair to good (-0.33 to -0.80 with Cobb angles and 0.76 for trunk list; P<0.05). CONCLUSION: This tool will facilitate clinical practice by monitoring trunk posture among persons with IS. Further, it may contribute to a reduction in the use of radiographs to monitor scoliosis progression.

Towards Non Invasive Diagnosis of Scoliosis Using Semi-supervised Learning Approach

In this paper, a new methodology for the prediction of scoliosis curve types from non invasive acquisitions of the back surface of the trunk is proposed. One hundred and fifty-nine scoliosis patients had their back surface acquired in 3D using an optical digitizer. Each surface is then characterized by 45 local measurements of the back surface rotation. Using a semi-supervised algorithm, the classifier is trained with only 32 labeled and 58 unlabeled data. Tested on 69 new samples, the classifier succeeded in classifying correctly 87.0% of the data. After reducing the number of labeled training samples to 12, the behavior of the resulting classifier tends to be similar to the reference case where the classifier is trained only with the maximum number of available labeled data. Moreover, the addition of unlabeled data guided the classifier towards more generalizable boundaries between the classes. Those results provide a proof of feasibility for using a semi-supervised learning algorithm to train a classifier for the prediction of a scoliosis curve type, when only a few training data are labeled. This constitutes a promising clinical finding since it will allow the diagnosis and the follow-up of scoliotic deformities without exposing the patient to X-ray radiations.

A Novel Method for the 3-D Reconstruction of Scoliotic Ribs From Frontal and Lateral Radiographs

Among the external manifestations of scoliosis, the rib hump, which is associated with the ribs' deformities and rotations, constitutes the most disturbing aspect of the scoliotic deformity for patients. A personalized 3-D model of the rib cage is important for a better evaluation of the deformity, and hence, a better treatment planning. A novel method for the 3-D reconstruction of the rib cage, based only on two standard radiographs, is proposed in this paper. For each rib, two points are extrapolated from the reconstructed spine, and three points are reconstructed by stereo radiography. The reconstruction is then refined using a surface approximation. The method was evaluated using clinical data of 13 patients with scoliosis. A comparison was conducted between the reconstructions obtained with the proposed method and those obtained by using a previous reconstruction method based on two frontal radiographs. A first comparison criterion was the distances between the reconstructed ribs and the surface topography of the trunk, considered as the reference modality. The correlation between ribs axial rotation and back surface rotation was also evaluated. The proposed method successfully reconstructed the ribs of the 6th-12th thoracic levels. The evaluation results showed that the 3-D configuration of the new rib reconstructions is more consistent with the surface topography and provides more accurate measurements of ribs axial rotation.

Non-invasive quantitative assessment of scoliosis spinal surgery outcome

Improving the appearance of the trunk is an important goal of scoliosis surgical treatment, mainly in patients' eyes. Unfortunately, existing methods for assessing postoperative trunk appearance are rather subjective as they rely on a qualitative evaluation of the trunk shape. In this paper, an objective method is proposed to quantify the changes in trunk shape after surgery. Using a non-invasive optical system, the whole trunk surface is acquired and reconstructed in 3D. Trunk shape is described by two functional measurements spanning the trunk length: the lateral deviation and the axial rotation. To measure the pre and postoperative differences, a correction rate is computed for both measurements. On a cohort of 36 scoliosis patients with the same spinal curve type who underwent the same surgical approach, surgery achieved a very good correction of the lateral trunk deviation (median correction of 76%) and a poor to moderate correction of the back axial rotation (median correction of 19%). These results demonstrate that after surgery, patients are still confronted with residual trunk deformity, mainly a persisting hump on the back. That can be explained by the fact that current scoliosis assessment and treatment planning are based solely on radiographic measures of the spinal deformity and do not take trunk deformity into consideration. It is believed that with our novel quantitative trunk shape descriptor, clinicians and surgeons can now objectively assess trunk deformity and postoperative shape and propose new treatment strategies that could better address patients' concern about their appearance. © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Patient-specific anisotropic model of human trunk based on MR data

There are many ways to generate geometrical models for numerical simulation, and most of them start with a segmentation step to extract the boundaries of the regions of interest. This paper presents an algorithm to generate a patient-specific three-dimensional geometric model, based on a tetrahedral mesh, without an initial extraction of contours from the volumetric data. Using the information directly available in the data, such as gray levels, we built a metric to drive a mesh adaptation process. The metric is used to specify the size and orientation of the tetrahedral elements everywhere in the mesh. Our method, which produces anisotropic meshes, gives good results with synthetic and real MRI data. The resulting model quality has been evaluated qualitatively and quantitatively by comparing it with an analytical solution and with a segmentation made by an expert. Results show that our method gives, in 90% of the cases, as good or better meshes as a similar isotropic method, based on the accuracy of the volume reconstruction for a given mesh size. Moreover, a comparison of the Hausdorff distances between adapted meshes of both methods and ground-truth volumes shows that our method decreases reconstruction errors faster. Copyright © 2015 John Wiley & Sons, Ltd.

Loop bifurcation and magnetization rotation in exchange-biased Ni/FeF2

Exchange-biased Ni/FeF2 films have been investigated using vector coil vibrating-sample magnetometry as a function of the cooling field strength HFC . In films with epitaxial FeF2 , a loop bifurcation develops with increasing HFC as it divides into two sub-loops shifted oppositely from zero field by the same amount. The positively biased sub-loop grows in size with HFC until only a single positively shifted loop is found. Throughout this process, the negative and positive (sub)loop shifts maintain the same discrete value. This is in sharp contrast to films with twinned FeF2 where the exchange field gradually changes with increasing HFC . The transverse magnetization shows clear correlations with the longitudinal subloops. Interestingly, over 85% of the Ni reverses its magnetization by rotation, either in one step or through two successive rotations. These results are due to the single-crystal nature of the antiferromagnetic FeF2 , which breaks down into two opposite regions of large domains.

Causes of legume-rotation effects in increasing cereal yields across the Sudanian, Sahelian and Guinean zone of West Africa

On-farm experiments and pot trials were conducted on eight West African soils to explore the mechanisms governing the often reported legume rotation-induced cereal growth increases in this region. Crops comprised pearl millet (Pennisetum glaucum L.), sorghum (Sorghum bicolor Moench), maize (Zea mays L.), cowpea (Vigna unguiculata Walp.) and groundnut (Arachis hypogaea L.). In groundnut trials the observed 26 to 85% increases in total dry matter (TDM) of rotation cereals (RC) compared with continuous cereals (CC) in the 4th year appeared to be triggered by site- and crop-specific early season differences in nematode infestation (up to 6-fold lower in RC than in CC), enhanced Nmin and a 7% increase in mycorrhizal (AM) infection. In cowpea trials yield effects on millet and differences in nematode numbers, Nmin and AM were much smaller. Rhizosphere studies indicated effects on pH and acid phosphatase activity as secondary causes for the observed growth differences between RC and CC. In the study region legume-rotation effects on cereals seemed to depend on the capability of the legume to suppress nematodes and to enhance early N and P availability for the subsequent cereal.

Cereal/legume rotation effects on rhizosphere bacterial community structure in West African soils

The increased use of cereal/legume crop rotation has been advocated as a strategy to increase cereal yields of subsistence farmers in West Africa, and is believed to promote changes in the rhizosphere that enhance early plant growth. In this study we investigated the microbial diversity of the rhizoplane from seedlings grown in two soils previously planted to cereal or legume from experimental plots in Gaya, Niger, and Kaboli, Togo. Soils from these legume rotation and continuous cereal plots were placed into containers and sown in a growth chamber with maize (Zea mays L.), millet (Pennisetum glaucum L.), sorghum (Sorghum bicolor L. Moench.), cowpea (Vigna unguiculata L.) or groundnut (Arachis hypogaea L.). At 7 and 14 days after sowing, 16S rDNA profiles of the eubacterial and ammoniaoxidizing communities from the rhizoplane and bulk soil were generated using denaturing gradient gel electrophoresis (DGGE). Community profiles were subjected to peak fitting analyses to quantify the DNA band position and intensities, after which these data were compared using correspondence and principal components analysis. The data showed that cropping system had a highly significant effect on community structure (p <0.005), irrespective of plant species or sampling time. Continuous cereal-soil grown plants had highly similar rhizoplane communities across crop species and sites, whereas communities from the rotation soil showed greater variability and clustered with respect to plant species. Analyses of the ammonia-oxidizing communities provided no evidence of any effects of plant species or management history on ammonia oxidizers in soil from Kaboli, but there were large shifts with respect to this group of bacteria in soils from Gaya. The results of these analyses show that crop rotation can cause significant shifts in rhizosphere bacterial communities.

Legume rotation effects on early growth and rhizosphere microbiology of sorghum in West African soils

Cereal yield increases in legume rotations on west African soils were the subject of much recent research aiming at the development of more productive cropping systems for the mainly subsistence-oriented agriculture in this region. However, little has been done to elucidate the possible contribution of soil microbiological factors to these rotation effects. Therefore a pot trial was conducted using legume rotation and continuous cereal soils each from one site in Burkina Faso and two sites in Togo where cropping system experiments had been conducted over 4 yrs. All soils were planted with seedlings of sorghum (Sorghum bicolor L. Moench). From 21 days after sowing onwards relative growth rates in rotation soils were higher than in the continuous cereal soils, resulting in between 69 and 500% higher shoot dry matter of rotation sorghum compared to sorghum growing in continuous cereal soils. Across sites rotation soils were characterized by higher pH, higher microbial N and a lower microbial biomass C/N ratio and, with the exception of one site, a higher fungal biomass in the rhizosphere. The bacterial and eukaryal community structure in the soil, assessed by denaturing gradient gel electrophoresis (DGGE), differed between sites. However, only at one site differed the bacterial and the eukaryal community structure in the rotation soil significantly from that in the continuous cereal soil. Although the results of this study confirmed the marked plantgrowth differences between sub-Saharan legume-rotation soils and their continuous cereal counterparts they also showed the difficulties to differentiate possible microbiological causes from their effects.

Causes of legume rotation induced yield increases in cereals grown on West African soils

This study was conducted to investigate soil biological and chemical factors that give rise to cereal yield enhancing effects of legume rotations on sandy, nutrient poor West African soils. The aim was not only to gain more information on the role of legume residues and microorganisms in the soil nutrient cycle. But the study aimed at evaluating if differences in substrate qualities (e.g. root residues) cause changes in the microbial community structure due to specific and highly complex microbe-root-soil interactions. Site and system specific reactions of microorganisms towards rewetting, simulating the onset of rainy season, were observed. Higher respiration rates, higher amounts of microbial biomass carbon (Cmic) and nitrogen (Nmic) as well as higher ergosterol, muramic acid, glucosamine and adenylate concentrations were measured in CL soils of Koukombo and in both soils from Fada. The immediate increase in ATP concentrations after rewetting was likely caused by rehydration of microbial cells where N was not immobilized and, thus, available for plants facilitating their rapid development. Legume root residues led only to slightly better plant performances compared to the control, while the application of cereal roots reduced seedling growth. In contrast to sorghum seedlings, the microbial community did not react to the mineral treatment. Thus the energy supply in form of organic amendments increased microbial indices compared to mineral P application and the control. The results of basal respiration rates, Cmic and Corg levels indicate that the microbial community in the soil from Koukombo is less efficient in substrate use compared to microorganisms in the soil from Fada. However, the continuous carbon input by legume root residues might have contributed to these differences in soil fertility. With the 33P isotopic exchange method a low buffering capacity was detected in both soils irrespective of treatments. Calculated E values (E1min to E1min-1d and E1d-3m) indicated a slowly release of P due to root turnover while applied mineral P is taken up by plants or fixed to the soil. Due to the fact that sorghum growth reacted mainly to the application of mineral P and the microorganisms solely to the organic inputs, the combination of both amendments seems to be the best approach to a sustainable increase of crop production on many nutrient-poor, sandy West African soils. In a pot experiment, were CC and CL soils from Fada and Koukombo were adjusted to the same level of P and N concentrations, crop growth was significantly higher on CL soils, compared to the respective treatments on CC soils. Mycorrhizal infection of roots was increased and the number of nematodes, predominantly free living nematodes, was almost halfed on rotation soils. In conclusion, increased nutrient availability (especially P and N) through the introduction of legumes is not the only reason for the observed yield increasing effects. Soil biological factors seem to also play an important role. In a root chamber experiment the pH gradient along the root-soil-interface was measured at three times using an antimony microelectrode. For Fada soils, pH values were higher on CL than CC soils while the opposite was true for the Koukombo soils. Site-specific differences between Fada and Koukombo soils in N content and microbial community structures might have created varying crop performances leading to the contrasting pH findings. However, the mechanisms involved in this highly complex microbe-root-soil interaction remain unclear.

Pathogens occuring in the winter pea-maize-winter wheat rotation, their host specificity and the potential of compost in suppressing foot and root disease of peas

The overall aim of the work presented was to evaluate soil health management with a specific focus on soil borne diseases of peas. For that purpose field experiments were carried out from 2009 until 2013 to assess crop performance and pathogen occurrence in the rotation winter pea-maize-winter wheat and if the application of composts can improve system performance. The winter peas were left untreated or inoculated with Phoma medicaginis, in the presence or absence of yard waste compost at rate of 5 t dry matter ha-1. A second application of compost was made to the winter wheat. Fusarium ssp. were isolated and identified from the roots of all three crops and the Ascochyta complex pathogens on peas. Bioassays were conducted under controlled conditions to assess susceptibility of two peas to Fusarium avenaceum, F. solani, P. medicaginis and Didymella pinodes and of nine plant species to F. avenaceum. Also, effects of compost applications and temperature on pea diseases were assessed. Application of composts overall stabilized crop performance but it did not lead to significant yield increases nor did it affect pathogen composition and occurrence. Phoma medicaginis was dominating the pathogen complex on peas. F. graminearum, F. culmorum, F. proliferatum, Microdochium nivale, F. crookwellense, F. sambucinum, F. oxysporum, F. avenaceum and F. equiseti were frequently isolated species from maize and winter wheat with no obvious influence of the pre-crop on the Fusarium species composition. The spring pea Santana was considerably more susceptible to the pathogens tested than the winter pea EFB33 in both sterile sand and non-sterilized field soil. F. avenaceum was the most aggressive pathogen, followed by P. medicaginis, D. pinodes, and F. solani. Aggressiveness of all pathogens was greatly reduced in non-sterile field soil. F. avenaceum caused severe symptoms on roots of all nine plant species tested. Especially susceptible were Trifolium repens, T. subterraneum, Brassica juncea and Sinapis alba in addition to peas. Reduction of growing temperatures from 19/16°C day/night to 16/12°C and 13/10°C did not affect the efficacy of compost. It reduced plant growth and slightly increased disease on EFB33 whereas the highest disease severity on Santana was observed at the highest temperature, 19/16°C. Application of 20% v/v of compost reduced disease on peas due to all four pathogens depending on pea variety, pathogen and growing media used. Suppression was also achieved with lower application rate of 3.5% v/v. Tests with γ sterilized compost suggest that the suppression of disease caused by Fusarium spp. is biological in origin, whereas chemical and physical properties of compost are playing an additional role in the suppression of disease caused by D. pinodes and P. medicaginis.