Han Ye, Fishbaugh James, Gonzalez Christian E, Aboyotes Donald A, Vicory Jared, Tang Simon Y, Paniagua Beatriz
Kitware, Inc., Clifton Park, NY 12065, USA.
Washington University in St. Louis, St. Louis, MO 63110, USA.
Shape Med Imaging (2023). 2023 Oct;14350:188-200. doi: 10.1007/978-3-031-46914-5_15. Epub 2023 Oct 31.
Non-specific lower back pain (LBP) is a world-wide public health problem that affects people of all ages. Despite the high prevalence of non-specific LBP and the associated economic burdens, the pathoanatomical mechanisms for the development and course of the condition remain unclear. While intervertebral disc degeneration (IDD) is associated with LBP, there is overlapping occurrence of IDD in symptomatic and asymptomatic individuals, suggesting that degeneration alone cannot identify LBP populations. Previous work has been done trying to relate linear measurements of compression obtained from Magnetic Resonance Imaging (MRI) to pain unsuccessfully. To bridge this gap, we propose to use advanced non-Euclidean statistical shape analysis methods to develop biomarkers that can help identify symptomatic and asymptomatic adults who might be susceptible to standing-induced LBP. We scanned 4 male and 7 female participants who exhibited lower back pain after prolonged standing using an Open Upright MRI. Supine and standing MRIs were obtained for each participant. Patients reported their pain intensity every fifteen minutes within a period of 2 h. Using our proposed geodesic logistic regression, we related the structure of their lower spine to pain and computed a regression model that can delineate lower spine structures using reported pain intensities. These results indicate the feasibility of identifying individuals who may suffer from lower back pain solely based on their spinal anatomy. Our proposed spinal shape analysis methodology have the potential to provide powerful information to the clinicians so they can make better treatment decisions.
非特异性下背痛（LBP）是一个全球性的公共卫生问题，影响着各个年龄段的人群。尽管非特异性下背痛的患病率很高且伴有相关经济负担，但该病症发生和发展的病理解剖学机制仍不清楚。虽然椎间盘退变（IDD）与下背痛有关，但有症状和无症状个体中均存在IDD，这表明仅退变并不能确定下背痛人群。此前曾尝试将磁共振成像（MRI）获得的压缩线性测量值与疼痛联系起来，但未成功。为了弥补这一差距，我们建议使用先进的非欧几里得统计形状分析方法来开发生物标志物，以帮助识别可能易患站立诱发下背痛的有症状和无症状成年人。我们使用开放式直立MRI对4名男性和7名女性参与者进行了扫描，这些参与者在长时间站立后出现下背痛。为每位参与者获取了仰卧位和站立位的MRI图像。患者在2小时内每隔15分钟报告一次疼痛强度。使用我们提出的测地线逻辑回归方法，我们将他们下脊柱的结构与疼痛联系起来，并计算了一个回归模型，该模型可以根据报告的疼痛强度描绘下脊柱结构。这些结果表明仅根据脊柱解剖结构识别可能患有下背痛个体的可行性。我们提出的脊柱形状分析方法有可能为临床医生提供有力信息，以便他们做出更好的治疗决策。
