The Development of Digitised Videoflouroscopy (DVF)
as a Clinical Tool for Measuring the Integrity
of the Living Spine
M. Kondracki, A. Breen, J. Muggleton & R. Allen
This is now the longest running of the College's joint research programmes. It addresses a fundamental set of issues in spinal research, based on the quantification of the motion mechanics of spinal linkages in disabled patients. It addresses difficult problems in clinical understanding, mechanical engineering and computing in order to provide a tool which is designed to bring evaluation to the spine's functional integrity within reach
A grant of £5000 from the INSTITUTE OF ORTHOPAEDICS supported a study of the detection of failure of spinal fusions. The pilot phase of this study suggested that DVF can supply this information and possibly prevent the need for unnecessary revision surgery.
A grant of £60,000 from the HENRY SMITH CHARITY which ended in 1995 was renewed by a grant for an identical sum. This supported a collaboration with the Department of Mechanical Engineering, Southampton University and has incorporated a full time chiropractic researcher at the AECC and a full time postdoctoral research fellow at the university.
Working simultaneously on the clinical and engineering components of this work, an analysis system was developed for an advanced PC-based environment and a great deal of experimentation with various bone marking methods was possible. Motorised equipment to examine the lumbar spine linkages under passive motion was built and refined and made ready for use. Protocols for the actual imaging procedures were developed in collaboration with the Radiology Department at the Salisbury District General Hospital. In addition work was begun to enable the elimination of videotape for interfacing for the direct transfer of intensifier images. A local medical ethics committee application was approved for the examination of a further 30 male volunteers and an update of radiation dosage was completed.
In another part of this work, the engineering Research Fellow experimented with a variety of computer algorithms for detecting the corners of vertebrae in the images and other algorithms for tracking them, as well as working with the clinical researcher in exploring template methods for labelling the images during tracking. Considerable efforts were needed to develop a method for recording motion X-ray images onto the computer with minimal loss of quality. This is essential if accurate measurements of motion are to be made. This has now been achieved and new software and hardware have been purchased to use in the process.
This work which in its initial stages was assisted by grants from the EUROPEAN CHIROPRACTORS UNION and the CHIROPRACTIC PATIENTS ASSOCIATION is now poised to answer one of the most challenging questions in chiropractic. This relates to how chiropractors can influence the motion of a specific spinal linkage. Subsidiary questions relating to the integrity of the spinal linkages , reflected in their motion, are still outstanding in the field of spinal disorders.
Return to New Research Projects