Morphometric evaluations of personalised 3D reconstructions and geometric models of the human spine.

In the past, several techniques have been developed to study and analyse the 3D characteristics of the human spine: multi-view radiographic or biplanar 3D reconstructions, CT-scan 3D reconstructions and geometric models. Extensive evaluations of three of these techniques that are routinely used at Sainte-Justine Hospital (Montréal, Canada) are presented. The accuracy of these methods is assessed by comparing them with precise measurements made with a coordinate measuring machine on 17 thoracic and lumbar vertebrae (T1-L5) extracted from a normal cadaveric spine specimen. Multi-view radiographic 3D reconstructions are evaluated for different combinations of X-ray views: lateral (LAT), postero-anterior with normal incidence (PA0 degree) and postero-anterior with 20 degrees angled down incidence (PA20 degrees). The following accuracies are found for these reconstructions obtained from different radiographic setups: 2.1 +/- 1.5 mm for the combination with PA0 degree-LAT views, and 5.6 +/- 4.5 mm for the PA0 degree-PA20 degrees stereopair. Higher errors are found in the postero-anterior direction, especially for the PA0 degree-PA20 degrees view combination. Pedicles are found to be the most precise landmarks. Accuracy for CT-scan 3D reconstructions is about 1.1 +/- 0.8 mm. As for a geometric model built using a multiview radiographic reconstruction based on six landmarks per vertebra, accuracies of about 2.6 +/- 2.4 mm for landmarks and 2.3 +/- 2.0 mm for morphometric parameters are found. The geometric model and 3D reconstruction techniques give accurate information, at low X-ray dose. The accuracy assessment of the techniques used to study the 3D characteristics of the human spine is important, because it allows better and more efficient quantitative evaluations of spinal dysfunctions and their treatments, as well as biomechanical modeling of the spine.