title: Spinal shape changes resulting from scoliotic spine surgical instrumentation expressed as intervertebral rotations and centers of rotation.
abstract: This paper reports the changes in spinal shape resulting from scoliotic spine surgical instrumentation expressed as intervertebral rotations and centers of rotation. The objective is to test the hypothesis that the type of spinal instrumentation system (Cotrel-Dubousset versus Colorado) does not influence these motion parameters. Intervertebral rotations and centers of rotation of the scoliotic spines were computed from the pre- and post-operative radiographs of 82 patients undergoing spinal correction. The three-dimensional (3D) reconstruction of six anatomical landmarks was achieved for each of the thoracic and lumbar vertebrae. A least-squares approach based on singular value decomposition was used to calculate the rigid body transformation parameters. Average centers of rotation for all intervertebral levels are located in the neural canal at the mid-sagittal plane and approximately at the superior endplate level of the inferior vertebra. Intervertebral rotations have components in all planes: 6.7 degrees (frontal), 5.5 degrees (sagittal) and 4.5 degrees (transverse) RMS for all intervertebral levels. Nearly all intervertebral rotations and centers of rotation are not significantly different for the two instrumentation systems. Various intervertebral rotations and 3D reconstruction errors were simulated on a theoretical model of a lumbar functional unit to assess the proposed method. Intervertebral rotation errors were 1.7 degrees when simulating 3D errors of 3mm on the position of the landmarks. Maximum errors for the position of centers of rotation were below 1cm in the case of intervertebral rotations larger than 2.5 degrees (most cases), but were larger (38 mm) for small intervertebral rotations (<1 degrees ). The type of instrumentation system did not influence intervertebral rotations and centers of rotation. These results provide valuable data for the development and validation of simulation models for surgical instrumentation of idiopathic scoliosis.
authors.affiliation: Department of Mechanical Engineering, Canada Research Chair "CAD Innovations in Orthopedic Engineering", Ecole Polytechnique de Montreal, PO Box 6079, Station "Centre-Ville", Montreal,Que, Canada H3C 3A7.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Petit
authors.forename: Carl-Eric
authors.initials: CE
authors.lastname: Aubin
authors.forename: Hubert
authors.initials: H
authors.lastname: Labelle
mesh_terms: D000328:Adult; D003198:Computer Simulation; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008954:Models, Biological; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D016059:Range of Motion, Articular; D012399:Rotation; D012600:Scoliosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome