Changes in Trunk Appearance After Scoliosis Spinal Surgery and Their Relation to Changes in Spinal Measurements

Study Design Retrospective study of surgical outcome. Objectives To evaluate quantitatively the changes in trunk surface deformities after scoliosis spinal surgery in Lenke 1A adolescent idiopathic scoliosis (AIS) patients and to compare it with changes in spinal measurements. Summary of Background Data Most studies documenting scoliosis surgical outcome used either radiographs to evaluate changes in the spinal curve or questionnaires to assess patients health-related quality of life. Because improving trunk appearance is a major reason for patients and their parents to seek treatment, this study focuses on postoperative changes in trunk surface deformities. Recently, a novel approach to quantify trunk deformities in a reliable, automatic, and noninvasive way has been proposed. Methods Forty-nine adolescents with Lenke 1A idiopathic scoliosis treated surgically were included. The back surface rotation and trunk lateral shift were computed on trunk surface acquisitions before and at least 6 months after surgery. We analyzed the effect of age, height, weight, curve severity, and flexibility before surgery, length of follow-up, and the surgical technique. For 25 patients with available three-dimensional (3D) spinal reconstructions, we compared changes in trunk deformities with changes in two-dimensional (2D) and 3D spinal measurements. Results The mean correction rates for the back surface rotation and the trunk lateral shift are 18% and 50%, respectively. Only the surgical technique had a significant effect on the correction rate of the back surface rotation. Direct vertebral derotation and reduction by spine translation provide a better correction of the rib hump (22% and 31% respectively) than the classic rod rotation technique (8%). The reductions of the lumbar Cobb angle and the apical vertebrae transverse rotation explain, respectively, up to 17% and 16% the reduction of the back surface rotation. Conclusions Current surgical techniques perform well in realigning the trunk; however, the correction of the deformity in the transverse plane proves to be more challenging. More analysis on the positive effect of vertebral derotation on the rib hump correction is needed. Level of evidence III.

Prediction of scoliosis curve type based on the analysis of trunk surface topography

Scoliosis treatment strategy is generally chosen according to the severity and type of the spinal curve. Currently, the curve type is determined from X-rays whose acquisition can be harmful for the patient. We propose in this paper a system that can predict the scoliosis curve type based on the analysis of the surface of the trunk. The latter is acquired and reconstructed in 3D using a non invasive multi-head digitizing system. The deformity is described by the back surface rotation, measured on several cross-sections of the trunk. A classifier composed of three support vector machines was trained and tested using the data of 97 patients with scoliosis. A prediction rate of 72.2% was obtained, showing that the use of the trunk surface for a high-level scoliosis classification is feasible and promising.

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.

Planning your literacy hour : trunk stories stages 1-9.

Está diseñado para ser utilizado para trabajar con toda la clase, el profesor puede organizar el trabajo, en grupo, y de forma independiente, y cuenta con el apoyo de materiales didácticos. Incluye planificación de lecciones, que abarcan el trabajo de toda la clase, guía del grupo en lectura y escritura, grupo de trabajo independiente. Proporciona directrices, libro por libro, sobre la mejor manera de utilizar los materiales a la hora de la lectura.

Development and experimental identification of a biomechanical model of the trunk for functional electrical stimulation control in paraplegia

Objectives. Theoretic modeling and experimental studies suggest that functional electrical stimulation (FES) can improve trunk balance in spinal cord injured subjects. This can have a positive impact on daily life, increasing the volume of bimanual workspace, improving sitting posture, and wheelchair propulsion. A closed loop controller for the stimulation is desirable, as it can potentially decrease muscle fatigue and offer better rejection to disturbances. This paper proposes a biomechanical model of the human trunk, and a procedure for its identification, to be used for the future development of FES controllers. The advantage over previous models resides in the simplicity of the solution proposed, which makes it possible to identify the model just before a stimulation session ( taking into account the variability of the muscle response to the FES). Materials and Methods. The structure of the model is based on previous research on FES and muscle physiology. Some details could not be inferred from previous studies, and were determined from experimental data. Experiments with a paraplegic volunteer were conducted in order to measure the moments exerted by the trunk-passive tissues and artificially stimulated muscles. Data for model identification and validation also were collected. Results. Using the proposed structure and identification procedure, the model could adequately reproduce the moments exerted during the experiments. The study reveals that the stimulated trunk extensors can exert maximal moment when the trunk is in the upright position. In contrast, previous studies show that able-bodied subjects can exert maximal trunk extension when flexed forward. Conclusions. The proposed model and identification procedure are a successful first step toward the development of a model-based controller for trunk FES. The model also gives information on the trunk in unique conditions, normally not observable in able-bodied subjects (ie, subject only to extensor muscles contraction).

Electrical stimulation for trunk control in paraplegia:A feasibility study

Paraplegic subjects lack trunk stability due to the loss of voluntary muscle control.This leads to a restriction of the volume of bi-manual workspace available,and hence has a detrimental impact on activities of daily living. Electrical Stimulation of paralysed muscles can be used to stabilize the trunk, but has never been applied in closed loop for this purpose. This paper describes the development of two closed loop controllers(PID and LQR),and their experimental evaluation on a human subject. Advantages and disadvantages of the two are discussed,considering a potential use of this technology during daily activities.

The Mystery of Privity: Grand Trunk Railway Company of Canada v Robinson (1915)

This article examines a little known decision of the Judicial Committee of the Privy Council: Grand Trunk Railway Company of Canada v Robinson (1915). The examination is historical and it provides a different insight into the understanding of privity of contract, a doctrine central to contract law. The examination reveals a process of trans-Atlantic legal migration in which English law was applied to resolve an Ontario case. The nature of the resolution is surprising because it appears to conflict with the better known decision of the House of Lords, Dunlop Pneumatic Tyre Company, Limited v Selfridge and Company, Limited, which a similarly constituted panel delivered in the same week. This article argues that there was a greater malleability in the resolution of cases concerned with privity than was thought to have existed. It is also argued that the power of Canadian railway capitalism is a significant factor in understanding the legal resolution of the case. Finally, it the article considers the use of English and American precedents relevant to the case. The application of English precedents to the case led to a resolution not entirely befitting Canadian conditions.

MUSCLE MASS GAIN AFTER RESISTANCE TRAINING IS INVERSELY CORRELATED WITH TRUNK ADIPOSITY GAIN IN POSTMENOPAUSAL WOMEN

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Are the anticipatory trunk movements occurring during load-carrying activities protective or risky?

This study evaluated anteroposterior trunk movements and the time spent on activities of load-carrying to surfaces at different heights, among experienced and inexperienced individuals. Thirty-six healthy males (16 experienced and 20 inexperienced in load-carrying) had their trunk movements recorded by an electrogoniometer while transporting boxes (7 and 15 kg) to surfaces of variable heights (low, low intermediate, high intermediate and high). Longer time was spent on trunk flexion when carrying loads to low surfaces and on trunk extension when carrying to high surfaces (p<0.05). Differences in time spent on trunk flexion/extension were identified between loads, and between groups for the heavier load. There were no differences in flexion/extension amplitudes between groups or loads. Although unnecessary flexion/extension occurring prior to a task may increase the exposure of the trunk to risky movements, the amplitudes reported here were relatively small and seemed to have occurred to facilitate the final tasks.Relevance to industryLifting devices and technological assistance are increasingly available in industrial settings. However, distribution centers and delivery services represent new demands on workers and involve an expressive amount of manual handling and carrying activities. Thus, studies on carrying strategies are necessary as they can provide guidelines for safer activities. (C) 2007 Elsevier B.V. All rights reserved.