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A major area of research in the Institute is the problem of measuring inter-vertebral mechanics in living subjects in order to understand better how common chronic spinal pain syndromes and biomechanics relate. The current methods of researching the association between mechanics and pain have relied heavily on studies of cadaveric spines in which restraining tissues are damaged and the biomechanical effects measured. The OSMIA project has had the aim of making these measurements possible in living subjects.
This has been done using digital fluoroscopy and image processing to give continuous inter-vertebral motion data as the person bends, either actively or passively. The video shows how images are acquired and how image processing is used to track them through a large series of images.
The results are shown as a series of graphs of the changing angles between the vertebrae, which appear as motion phenotypes that are both reproducible and characteristic of the patterns of restraint in that individual person and level.
The Institute has worked to develop this technology and interpret the meaning of its output over many years, culminating in a grant by the NHS R&D’s New and Emerging Applications of Technology programme (NEAT) 1-22
In February, 2009, the College purchased a new portable C-Arm Fluoroscope to enable this research to be conducted on site. Three staff members, a chiropractor/bioengineer, a research radiographer, who is a PhD student, and a medical physicist are currently engaged on the OSMIA projects. These are supported by two staff radiographers. A second post-graduate is planned to begin doctoral level work next year.
Breen, A.C., Teyhan, D.S., Mellor, F.E., Breen, A.C. jnr., Wong, K.W.N., Deitz, A. Measurement on Intervertebral Motion Using Quantitative Fluoroscopy: Report of an International Forum and Proposal for Use in the Assessment of Degenerative Disc Disease in the Lumbar Spine. Advances in Orthopaedics: vol 2012
Breen A, Mellor F, Fowler J., Adjacent segment motion and posterior lumbar spine instrumention: a comparison of patient groups. Spine Arthroplasty Society. Global Symposium on Motion Preservation Technology; 2007; Berlin.
Mellor F, Breen, A., Fowler, J.. Senior, C., Muggleton, J., Hogg, J. Sensitivity and Specificity of Objective Spinal Motion Imaging Analysis (OSMIA) in Detecting Lumbar Discs that have Significant MR Degeneration European Conference on Radiology. Vienna, 2007.
Breen A, Mellor, F., Muggleton, J., Morris, A., Fowler, J., Mason, W., Bagust, J., Senior, C. Lumbar Inter-vertebral side-bending motion in asymptomatic subjects. Spine Society ofEurope. Annual Meeting. Istanbul, 2006.
Breen A, Muggleton, J., Mellor, F. An objective spinal motion imaging assessment (OSMIA): reliability, accuracy and exposure data. BMC Musculoskeletal Disorders 2006;7(1):1-10.
Breen A, Muggleton, J., Mellor, F., Morris, A., Eisenstein, S., Thomas, L. Lumbar intervertebral motion in asymptomatic and post fusion subjects. J Bone Joint Surgery BrProceedings 2005;87-B::35.
Eisenstein S, Breen A. Lumbar fusion: looking for failure. In: Szpalski M, Gunzburg R, editors. The Failed Spine. Philadelphia: Lippincott Williams & Wilkins, 2005:25-33.
Breen A. A new technique for the quantification of intervertebral motion in vivo: A brief overview. Bournemouth, UK: IMRCI, AECC, 2003:1-3.
Breen A, Muggleton, J., Mellor, F., Morris, A., Eisenstein, S., Thomas, L. Tracking fluoroscopic images to assess the integrity of lumbar spine fusion. RAD Magazine 2003(August):31.
Breen AC, Mellor F, Muggleton J. An objective spinal imaging assessment (OSMIA) of the integrity of lumbar spine stabilisation grafts. European Congress of Radiology; 2003 7-11 March; Vienna, Austria.
Breen A, Muggleton, J., Kondracki, M., Wright, J, Morris, A. Lumbar spine motion palpation compared with objective intervertebral motion analysis: prelimary findings. EuropeanJournal of Chiropractic 2002;50:27-32.
Breen AC, Allen R. Digital videofluoroscopy and abnormal spinal movement. In: Aspden RM, Porter RW, editors. Lumbar Spine Disorders: Current Concepts. Singapore: World Scientific, 1996:79-88.
Breen AC, Brydges, R., Nunn, H., Kause, J., Allen, R. Quantitative analysis of lumbar spine intersegmental motion. European Journal of Physical Medicine and Rehabilitation 1993;3(5):182-90.
Kondracki M, Breen AC. Indices of regularity and laxity in the motion between lumbar vertebrae in the sagittal plane. London: Society for Back Pain Research, 1993.
Bracale M, Denoth F, editors. The use of digitised videofluoroscopic images in the analysis of spinal mechanics in-vivo. VI Mediterranean Conference on Medical and Biological Engineering; 1992; Capri. CNR.
Breen A. Integrated spinal motion: a study of two cases. JCCA 1991;35(1):25-30.
Breen AC. The analysis of spine kinematics using digital videofluoroscopy. 7th European Society of Biomechanics; 1990; Aarhus, Denmark.
Breen AC. The measurement of the kinematics of the human spine using digital videofluoroscopy. Southampton: University of Southampton, 1989.
Breen AC, Allen, R., Morris, A. Spine kinematics: a digital videofluoroscopic technique. Journal of Biomedical Engineering 1989;11:224-8.
Breen AC, Allen, R., Morris, A. An image processing method for spine kinematics-preliminary studies. Clinical Biomechanics 1988;3:5-10.
Breen AC. A computer/x-ray method for measuring spinal segmental movement: a feasibility study. 2nd Annual Conference on Research and Education of the Pacific Consortium for Chiropractic Research; 1987 June 13-14; Belmont, California, USA.