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Prediction outcomes for anterior vertebral body growth modulation surgery from discriminant spatiotemporal manifolds

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Anterior vertebral body growth modulation (AVBGM) is a minimally invasive surgical technique that gradually corrects spine deformities while preserving lumbar motion. However, identifying suitable patients for surgery is based on clinical judgment and surgical experience. This process would be facilitated by the identification of patients responding to AVBGM prior to surgery using data-driven models trained on previous instrumented cases.

Methods

We introduce a statistical framework for predicting the surgical outcomes following AVBGM in adolescents with idiopathic scoliosis. A discriminant manifold is first constructed to maximize the separation between responsive and non-responsive groups of patients treated with AVBGM for scoliosis. The model then uses subject-specific correction trajectories based on articulated transformations in order to map spine correction profiles to a group-average piecewise-geodesic path. Spine correction trajectories are described in a piecewise-geodesic fashion to account for varying times at follow-up examinations, regressing the curve via a quadratic optimization process. To predict the evolution of correction, a baseline reconstruction is projected onto the manifold, from which a spatiotemporal regression model is built from parallel transport curves inferred from neighboring exemplars.

Results

The model was trained on 438 reconstructions and tested on 56 subjects using 3D spine reconstructions from follow-up examinations, with the probabilistic framework yielding accurate results with differences of \(2.1^{\circ }\pm 0.6^{\circ }\) in main curve angulation and a classification rate of 83.2%, and generating models similar to biomechanical simulations.

Conclusion

The proposed method achieved a higher prediction accuracy and improved the modeling of spatiotemporal morphological changes in surgical patients treated with AVBGM.

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Acknowledgements

The authors would like to thank Christian Bellefleur and Philippe Labelle for their help in data curation and 3D reconstructions.

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Authors and Affiliations

  1. Polytechnique Montréal, Institute of Biomedical Engineering, Montreal, QC, Canada

    William Mandel & Samuel Kadoury

  2. Centre Hospitalier Universitaire Sainte-Justine de Montréal Research Center, Montreal, QC, Canada

    Olivier Turcot, Stefan Parent & Samuel Kadoury

  3. Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia

    Dejan Knez

  4. Centre Hospitalier de l’Université de Montréal Research Center, Montreal, QC, Canada

    Samuel Kadoury

Authors
  1. William Mandel
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  2. Olivier Turcot
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  3. Dejan Knez
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  4. Stefan Parent
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  5. Samuel Kadoury
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Corresponding author

Correspondence to Samuel Kadoury.

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Funding

This study funded by the Canada Research Chairs (950-228359) and the National Science and Engineering Research Council (NSERC) of Canada.

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

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Mandel, W., Turcot, O., Knez, D. et al. Prediction outcomes for anterior vertebral body growth modulation surgery from discriminant spatiotemporal manifolds. Int J CARS 14, 1565–1575 (2019). https://doi.org/10.1007/s11548-019-02041-w

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  • DOI: https://doi.org/10.1007/s11548-019-02041-w

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