Safer and improved technologies for detecting and treating scoliosis

Calgary researchers, healthcare providers and local patients are working together to develop a high-tech imaging system for detecting and treating of scoliosis – a mysterious spinal condition that affects about one out of every 200 people, especially children.

U of C researchers at the Calgary Centre for Innovative Technology (CCIT) are collaborating with doctors and staff at the Alberta Children’s Hospital (ACH) on a non-invasive, portable, 3D imaging system to diagnose and monitor scoliosis in patients. This imaging system would allow doctors to do more accurate testing of patients in less time and allow patients to avoid potentially harmful x-rays during their treatment.

The researchers are also using new imaging technology to produce customized torso braces for patients, which are used to keep mild cases of scoliosis from progressing. Currently, standard, pre-made braces don’t fit well enough on an estimated 40 per cent of patients and therefore aren’t as effective as they could be.

Scoliosis is also known as curvature of the spine. A normal spine curves slightly backward at the chest and slightly forward at the abdomen with no lateral curving. Scoliosis involves an exaggerated, C- or S-shaped lateral curvature of the spine associated with deformity of the ribs and asymmetry of the trunk. While a majority of cases can be treated effectively if detected early, severe cases that are neglected can progress dramatically, causing pain, osteoarthritis, physical deformities or potentially lethal complications, such as heart and lung problems.

Currently, scoliosis patients typically go for x-rays twice a year so doctors can monitor the condition. However, this means patients are exposed to a lot of radiation and the risk of cancer. Instead of multiple x-rays, a multidisciplinary group of Calgary engineering, kinesiology and medical researchers are digitally imaging patients’ torsos using an optical scanning system and a 3D stereo radiographic reconstruction technique. These two technologies provide doctors with more detail of the deformity.

“When you look at the X-ray film, you may think that scoliosis is just a lateral deformity of the spine, with the spine going to the left or to the right. However, it is actually a three-dimensional deformation,” says CCIT researcher and U of C postdoctoral fellow Dr. Philippe Poncet, who is working on the project with Dr. James Harder of the Alberta Children’s Hospital; Dr. Janet Ronsky, the U of C’s Canada Research Chair in Biomedical Engineering; Dr. Ron Zernicke, Dean of the Faculty of Kinesiology; and several other U of C professors and students as well as doctors and staff at the Alberta Children’s Hospital.

Testing of the new methods has been underway since 1997. As a part of the project, the U of C researchers have been scanning about 100 patients’ torsos at the Alberta Children’s Hospital.

The imaging technique – using the Phase Shifted Moiré Projection Technique – employs four expensive scanning cameras and a walk-in frame to hold the patients perfectly still. A predictive model, based on what is called the Neural Networks Approach, then estimates the spinal deformity from the data of the torso scans.

To date, the Calgary research team has been able to estimate the deformity of the spine with an accuracy of about 10 degrees for 95 per cent of the patients and within five degrees on two-thirds of the patients. “What we are working on now is optimizing the technology to further improve the accuracy,” says Poncet. “To use it as a clinical tool, it needs to be even more accurate, but we are close to what the doctors need.”

As well, researchers are also hoping to develop math and computer models to provide doctors with accurate predictions on how a patient’s condition may progress. “The idea is that after a taking few measurements of the patients’ torsos, the doctors will be able to use a model to predict whose spinal curves will get worse and whose won’t,” says Zernicke.

Zernicke credits the laser scanning technology originally developed for designing prosthetic devices for sparking the scoliosis project. This technology was developed by Clynch Technologies Inc. (a company founded by Calgary innovator George Clynch). Besides making customized prosthetics, today this imaging technology is commonly used in the animation and video game industries.

The research project is supported by the Fraternal Order of Eagles (which provided crucial seed funding for the project), NSERC (Science and Engineering Research Canada), the Canadian Institutes of Health Research, the Alberta Heritage Foundation for Medical Research, the Alberta Children’s Hospital Foundation, the Hospital for Sick Children Foundation and the Arthritis Society.

Other institutions collaborating on the project include Montreal’s Ecole Polytechnique and Saint-Justine Hospital as well as Clynch Technologies Inc. and InSpeck Inc.

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