Paediatric spine research group

Overview

The QUT/Mater Hospitals Paediatric Spine Research Group (PSRG) is a collaboration between QUT, Mater Health Services Brisbane Ltd, and the Queensland Orthopaedic Research Trust. Our research focus is paediatric spinal deformity, with an emphasis on surgical correction of adolescent idiopathic scoliosis.

Read details

Research team
QUT External collaborators
  • Dr Geoff Askin, Spinal surgeon, Mater hospitals
  • Dr Rob Labrom, Spinal surgeon, Mater hospitals
  • Dr John Earwaker, Radiologist, Mater hospitals
Organisational unit
Lead unit Science and Engineering Faculty

Contact

Paediatric Spine Research Group

Level 2 administration
Mater Childrens Hospital
Raymond Terrace
South Brisbane, QLD 4101
AUSTRALIA

Telephone: +61 7 3163 6163
Fax: +61 7 3163 1744
Email: spineresearch@mater.org.au

 

Details

Patient-specific biomechanical modelling for improved treatment of spinal deformity

Paediatric spine - treatment
Paediatric spine - treatment 2

Spinal deformities are debilitating and disfiguring conditions which strike the young and otherwise healthy, especially girls. In Australia there are over 50,000 adolescents with idiopathic scoliosis, a deformity for which neither a cause nor cure has been discovered. Modern spinal implants apply targeted corrective forces, however, excessive force an overload spinal joints and vertebrae leading to tissue damage, implant breakage and loss of correction after surgery. Predicting the limits of correction achievable in a particular patient requires biomechanical models of spinal tissues and implants. This project has developed new modelling techniques to optimise deformity correction and avoid implant-related complications.

Researchers in the Paediatric Spine Research Group hope to use these new computer models to assist surgeons in better predicting surgical outcomes for scoliosis patients. The computer models are developed using patient CT data and include representations for the bone geometry and spinal soft tissues as well as the devices implanted by the surgeon. These devices include metal rods which are attached to the patient's spine with screws (Figure 1) and tightened to correct the spinal deformity (Figure 2).

By simulating the loads applied to the patient's spine during daily activities, it is possible to predict stresses and strains in the implant and spinal tissues. Using this information, possible overload of the spine and implant materials can be predicted and thus, possible damage to the spine avoided. It is hoped that by predicting the outcomes of surgical procedures before they are carried out, this will reduce the possibility of surgical complications and improve patient outcomes following scoliosis surgery.

Finite element simulation for prediction of micro-crack formation in trabecular bone

Paediatric spine - micro-crack

Trabecular bone plays an important load-bearing role in the spine. High loads or insertion of implants can damage trabecular bone, causing micro-cracking of individual trabeculae. Micro-crack formation is important since small cracks cannot be detected on medical images, yet they play a key role in inducing either bone repair or resorption (bone loss). The Paediatric Spine Research Group is using finite element modelling combined with high resolution imaging and mechanical testing to provide insights into micro-crack formation. The project will develop techniques to predict the response to applied loads of both normal and ageing trabecular bone in the spine.

Investigating the effect of axial compression on vertebral rotation in spinal deformity patients

Paediatric spine - spinal deformity

Axial rotation of vertebrae is a defining feature of scoliotic spine deformity. Axial rotation of vertebrae causes deformation of the ribcage, manifest as a noticeable "rib hump". Aside from the undesirable cosmetic appearance, deformation of the ribcage can cause respiratory problems in severe cases. Correction of axial rotation and associated reduction in rib hump is a goal of spine deformity surgery, but this goal is rarely achieved, especially with single rod instrumentation which has limited ability to apply torsional corrective forces to the spine.

This study will investigate the relationship between axial compression and vertebral rotation in pre-operative spine deformity patients by applying an axial compressive force to subjects as they undergo magnetic resonance (MR) imaging. We hypothesize that axial compressive force significantly affects both the curvature and vertebral rotation of the spine and ribcage. This relationship has implications for both pre-operative medical imaging and surgical planning.

Partnerships

  • Mater Health Services Brisbane Ltd
  • Queensland Orthopaedic Research Trust

Publications and output

Selected journal publications

  • Adam CJ, Askin GN. Automatic measurement of vertebral rotation in idiopathic scoliosis. Spine (in press, accepted 8th Jul 2005)
  • Adam CJ, 2005. The geometry of a circular arc does not accurately describe spinal curvature in scoliosis. Journal of the National Medical Association 97(8):1179-80.
  • Adam CJ, Izatt MT, Harvey J, Askin GN, 2005. Variability in Cobb angle measurements using reformatted computed tomography scans. Spine 30(14):1664-69.
  • Fagan AB, Askin GN, Earwaker JWS, 2004. The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum. European Spine Journal 13(4):295-300.

Selected conference presentations

  • Askin GN, Labrom R, Izatt MT, Adam CJ, 2005. Relationship between Curve Correction and SRS 24 Questionnaire Outcomes in Endoscopic Scoliosis Surgery. Scoliosis Research Society Annual Meeting and Conference, Miami, Florida, USA. October 27-30.
  • Gatehouse S, Izatt MT, Labrom R, Adam CJ, Askin GN, 2005. Medical Aspects of Endoscopic Scoliosis Surgery. Asia Pacific Spinal Deformity Conf., August 25-27.
  • Adam CJ, Izatt MT, Askin GN, Labrom R, 2005. SRS 24 and Endoscopic Scoliosis Surgery. Asia Pacific Spinal Deformity Conf., August 25-27.
  • Adam CJ, Pearcy MJ and Askin GN, 2005. Gravity-induced torsion and intravertebral rotation in idiopathic scoliosis. Proceedings of the Harrington Spine Symposium, Kansas City, USA, 28-30 July.
  • Harvey JR, Izatt MT, Adam CJ, Askin GN, 2005. Respiratory Function following Endoscopic Spinal Surgery. IMAST 2005, 7-9 July, Banff, Canada.
  • Adam CJ, Earwaker JW, Askin GN, 2005. Pre-operative computed tomography scans for planning endoscopic scoliosis surgery. IMAST 2005, 7-9 July, Banff, Canada.
  • Little JP, Adam CJ, Evans JH, Pettet G, Pearcy MJ, 2005. Finite element analysis of anular lesions in the intervertebral disc. Proceedings of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon, Portugal, 4-7 June, Paper No. 2408.
  • Adam CJ, Pearcy MJ, and Askin GN, 2004, Patient-specific finite element analysis of single rod adolescent idiopathic scoliosis surgery. Proceedings of the First Asian-Pacific Conference on Biomechanics, Osaka, Japan, 25-28 March, pp 201-202.
  • Adam CJ, Pearcy MJ, and Askin GN, 2004, Development of patient-specific computer simulation tools for endoscopic scoliosis surgery. International Research Society of Spinal Deformities Symposium 2004 (ed. Bonita J Sawatzky), Vancouver, Canada, 10-12 June, pp 162-165.
  • Fagan AB, Eames N, Askin GN, 2004. Thorascopic correction of scoliosis. Journal of Bone and Joint Surgery Proceedings, Nov 2004, 86-B, p492.
  • Fagan AB, Askin GN, Earwaker JWS, 2004. The jigsaw sign: a reliable sign of congenital aetiology in os odontoideum. Journal of Bone and Joint Surgery Proceedings, Nov 2004, 86-B, p489.
  • Harvey JR, Fender D, Askin GN, 2004. Management of Paediatric chance fractures. Journal of Bone and Joint Surgery Proceedings, Nov 2004, 86-B, p463.
  • Williams RP, Thorpe PLPJ, Goss B, Askin GN, 2004. Reliability of CT based classification of incorporation of femoral allograft in anterior column reconstruction of the thoracolumbar spine. Journal of Bone and Joint Surgery Proceedings, Nov 2004, 86-B, p463.
  • Fender D, Askin GN, 2004. Respiratory function and endoscopic scoliosis. Journal of Bone and Joint Surgery Proceedings, April 2004, 86-B, p93.
  • Fender D, Astori I, Askin GN, 2004. Thorascopic anterior release - a new technique. Journal of Bone and Joint Surgery Proceedings, April 2004, 86-B, p91.
  • Smallhorn JP, Adam CJ, Pettet G, Pearcy MJ, 2003. Mechanical derangement of the matrix in the Anulus Fibrosus. Proceedings of the World Congress on Medical Physics and Biomedical Engineering, Sydney, Australia, 24-29 Aug, ISBN 1877040142, Paper No. 2322 (CD-ROM).
  • Fagan AB, Eames N, Askin GN, 2002. Thorascopic correction of scoliosis: An update. Journal of Bone and Joint Surgery Proceedings, Vol 84 Supplement 3.
  • Smallhorn JP, Pearcy MJ, Adam CJ, Evans, JH, Pettet G, 2001. Development of a finite element model of the L4/5 lumbar intervertebral disc. Proceedings of the Fifth International Symposium on Computer Methods in Biomechanics and Biomedical Engineering, Rome, Italy, 31 Oct-3 Nov, Paper No. 90S
  • Eames N, Lisle D, Askin GN, 2001. Radiographic analysis of spinal movement following thoracolumbar fracture fixation. Journal of Bone and Joint Surgery Proceedings, Vol 84 Supplement 3.
  • Eames N, Askin GN, 2001. Initial results of endoscopic correction for idiopathic thoracic scoliosis. Journal of Bone and Joint Surgery Proceedings, Vol 83 Supplement 3.
  • Eames N, Askin GN, 2001. Junctional kyphosis above the instrumentation in adult scoliosis surgery. Journal of Bone and Joint Surgery Proceedings, Vol 83 Supplement 3.