Descripción del proyecto
Estrategias quirúrgicas personalizadas contra la dorsalgia crónica
La dorsalgia crónica, causada principalmente por factores biomecánicos, puede provocar discapacidad. En los pacientes mayores, el contexto biomecánico se complica por la osteoporosis, lo cual requiere una intervención quirúrgica para tratar el dolor relacionado con la inestabilidad y restablecer el equilibrio de la columna vertebral. Sin embargo, la elección del momento de la intervención sigue siendo subjetiva y se basa en la experiencia del cirujano. En los últimos tiempos se han establecido criterios objetivos basados en imágenes para predecir el resultado de la cirugía. El equipo del proyecto iBack, financiado por el Consejo Europeo de Investigación, tiene como objetivo mejorar la comprensión del dolor asociado a la inestabilidad y desarrollar estrategias quirúrgicas personalizadas para los pacientes con dorsalgia. Se mejorarán las imágenes «in vivo» y el análisis de imágenes para crear modelos biomecánicos individualizados que revelen el proceso fisiopatológico subyacente. Gracias a ello, será posible planificar tratamientos personalizados y predecir los resultados tras una intervención quirúrgica o un tratamiento conservador de la columna vertebral.
Objetivo
Chronic back pain is a major burden and source of disability worldwide. It is primarily attributed to biomechanical factors. In elderly patients, osteoporosis complicates the biomechanical scenario. Surgery is often required to treat instability-related pain and to restore the balance of the spine. However, when and how to perform surgery remains a highly subjective decision based on the surgeon’s experience, with 2/3 of patients experiencing prolonged pain.
We recently established objective, image-based criteria for surgery outcome prediction. As an example, we were able to develop tools for routine density and fracture assessment and demonstrate that screw loosening occurs in >85% of patients with bone mineral density <92 mg/ccm. This directly influences the surgical approach in all spine surgery patients at our institution. Additionally, we improved the prediction of bone strength by advanced image post processing such as scaling indices, finite element and finite cell models.
The high-level objective of iBack is to individualize therapy planning in back pain patients. We will improve in-vivo imaging and image analysis to compute individualized biomechanical models that reveal the underlying pathophysiologic process and allow personalized treatment planning and outcome prediction after spine surgery or conservative treatment.
The main objectives of iBack are: (1) improving computed tomography (CT) and magnetic resonance imaging (MRI) of the spine; (2) combining sagittal balance radiographs, CT and MRI of the spine in one biomechanical multi-body simulation (MBS); (3) creating a statistical model that includes both clinical and biomechanical information to reveal interactions between the two and to predict individual treatment success probability.
The results of iBack will help to better understand instability-related pain and develop personalized surgical strategies which will have major impacts on patients.
Ámbito científico
- engineering and technologyelectrical engineering, electronic engineering, information engineeringelectronic engineeringsignal processingcompressed sensing
- medical and health sciencesclinical medicinesurgery
- engineering and technologymedical engineeringdiagnostic imagingcomputed tomography
- engineering and technologymedical engineeringdiagnostic imagingmagnetic resonance imaging
- natural sciencesmathematicsapplied mathematicsstatistics and probability
Programa(s)
Régimen de financiación
ERC-STG - Starting GrantInstitución de acogida
81675 Muenchen
Alemania