Huang Le, Chun Keum San, Yu Lian, Lee Jong Yoon, Soetikno Alan, Chen Hope, Jeong Hyoyoung, Barrett Joshua, Martell Knute, Kang Youn, Patel Alpesh A, Xu Shuai
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Sibel Health, Niles, IL, USA.
Digit Biomark. 2024 Apr 10;8(1):40-51. doi: 10.1159/000536473. eCollection 2024 Jan-Dec.
Cervical spine disease is a leading cause of pain and disability. Degenerative conditions of the spine can result in neurologic compression of the cervical spinal cord or nerve roots and may be surgically treated with an anterior cervical discectomy and fusion (ACDF) in up to 137,000 people per year in the United States. A common sequelae of ACDF is reduced cervical range of motion (CROM) with patient-based complaints of stiffness and neck pain. Currently, tools for assessment of CROM are manual, subjective, and only intermittently utilized during doctor or physical therapy visits. We propose a skin-mountable acousto-mechanic sensor (ADvanced Acousto-Mechanic sensor; ADAM) as a tool for continuous neck motion monitoring in postoperative ACDF patients. We have developed and validated a machine learning neck motion classification algorithm to differentiate between eight neck motions (right/left rotation, right/left lateral bending, flexion, extension, retraction, protraction) in healthy normal subjects and patients.
Sensor data from 12 healthy normal subjects and 5 patients were used to develop and validate a Convolutional Neural Network (CNN).
An average algorithm accuracy of 80.0 ± 3.8% was obtained for healthy normal subjects (94% for right rotation, 98% for left rotation, 65% for right lateral bending, 87% for left lateral bending, 89% for flexion, 77% for extension, 50% for retraction, 84% for protraction). An average accuracy of 67.5 ± 5.8% was obtained for patients.
ADAM, with our algorithm, may serve as a rehabilitation tool for neck motion monitoring in postoperative ACDF patients. Sensor-captured vital signs and other events (extubation, vocalization, physical therapy, walking) are potential metrics to be incorporated into our algorithm to offer more holistic monitoring of patients after cervical spine surgery.
颈椎病是疼痛和残疾的主要原因。脊柱的退行性病变可导致颈脊髓或神经根的神经受压,在美国每年多达137,000人可能接受颈椎前路椎间盘切除融合术(ACDF)进行手术治疗。ACDF的一个常见后遗症是颈椎活动范围(CROM)减小,患者会抱怨颈部僵硬和疼痛。目前,评估CROM的工具是手动的、主观的,并且仅在医生或物理治疗就诊期间间歇性使用。我们提出一种可贴于皮肤的声机械传感器(先进声机械传感器;ADAM)作为术后ACDF患者颈部运动连续监测的工具。我们已经开发并验证了一种机器学习颈部运动分类算法,以区分健康正常受试者和患者的八种颈部运动(右/左旋、右/左侧弯、前屈、后伸、回缩、前伸)。
来自12名健康正常受试者和5名患者的传感器数据用于开发和验证卷积神经网络(CNN)。
健康正常受试者的算法平均准确率为80.0±3.8%(右旋94%,左旋98%,右侧弯65%,左侧弯87%,前屈89%,后伸77%,回缩50%,前伸84%)。患者的平均准确率为67.5±5.8%。
ADAM与我们的算法一起,可作为术后ACDF患者颈部运动监测的康复工具。传感器捕获的生命体征和其他事件(拔管、发声、物理治疗、行走)是潜在的指标,可纳入我们的算法,以便对颈椎手术后的患者进行更全面的监测。