Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, 2-15-45 Mita, Minato-Ku, Tokyo, 108-8345, Japan.
BMC Med Imaging. 2022 Nov 8;22(1):193. doi: 10.1186/s12880-022-00923-1.
Cervical myelopathy is a progressive disease, and early detection and treatment contribute to prognosis. Evaluation of cervical intervertebral instability by simple X-ray is used in clinical setting and the information about instability is important to understand the cause of myelopathy, but evaluation of the intervertebral instability by X-ray is complicated. To reduce the burden of clinicians, a system that automatically measures the range of motion was developed by comparing the flexed and extended positions in the lateral view of a simple X-ray of the cervical spine. The accuracy of the system was verified by comparison with spine surgeons and residents to determine whether the system could withstand actual use.
An algorithm was created to recognize the four corners of the vertebral bodies in a lateral cervical spine X-ray image, and a system was constructed to automatically measure the range of motion between each vertebra by comparing X-ray images of the cervical spine in extension and flexion. Two experienced spine surgeons and two residents performed the study on the remaining 23 cases. Cervical spine range of motion was measured manually on X-ray images and compared with automatic measurement by this system.
Of a total of 322 cervical vertebrae in 46 images, 313 (97%) were successfully estimated by our learning model. The mean intersection over union value for all the 46-test data was 0.85. The results of measuring the CRoM angle with the proposed cervical spine motion angle measurement system showed that the mean error from the true value was 3.5° and the standard deviation was 2.8°. The average standard deviations for each measurement by specialist and residents are 2.9° and 3.2°.
A system for measuring cervical spine range of motion on X-ray images was constructed and showed accuracy comparable to that of spine surgeons. This system will be effective in reducing the burden on and saving time of orthopedic surgeons by avoiding manually measuring X-ray images. Trial registration Retrospectively registered with opt-out agreement.
颈椎病是一种进行性疾病，早期发现和治疗有助于改善预后。临床评估颈椎椎间不稳定通常采用简单的 X 射线检查，了解不稳定的信息对于明确颈椎病的病因很重要，但 X 射线评估椎间不稳定较为复杂。为了减轻临床医生的负担，通过比较颈椎侧位屈伸位 X 射线片，开发了一种自动测量运动范围的系统。通过与脊柱外科医生和住院医师进行比较，验证了该系统的准确性，以确定该系统是否能够实际使用。
创建了一种算法来识别颈椎侧位 X 射线图像中椎体的四个角，并构建了一个系统，通过比较颈椎伸展和屈曲的 X 射线图像，自动测量每个椎体之间的运动范围。两名经验丰富的脊柱外科医生和两名住院医师对其余 23 例患者进行了研究。在 X 射线图像上手动测量颈椎运动范围，并与该系统的自动测量结果进行比较。
在 46 张图像的 322 个颈椎中，我们的学习模型成功估计了 313 个（97%）。所有 46 个测试数据的平均交并率为 0.85。使用所提出的颈椎运动角度测量系统测量 CRoM 角度的结果表明，与真实值的平均误差为 3.5°，标准差为 2.8°。专家和住院医师每次测量的平均标准差分别为 2.9°和 3.2°。
构建了一种用于在 X 射线图像上测量颈椎运动范围的系统，其准确性可与脊柱外科医生相媲美。该系统通过避免手动测量 X 射线图像，将有效减轻骨科医生的工作负担并节省时间。
Retrospectively registered with opt-out agreement.
