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Développement d'un modèle biomécanique du rachis basé sur les relations 3D internes – externes : radiographie bi-planaire et franges de Moiré

Abstract : Nowadays, radiography is the gold standard for the follow up of spinal pathologies. Furthermore, bi-planar radiography allows the assessment of vertebrae configuration, by 3D reconstruction. However, multiple radiographic examinations during childhood and adolescence increase the risk of breast cancer among women. To reduce radiation doses, some radiographic assessments could be replaced by the back surface evaluation. This kind of non-invasive procedure allows for acquisition of many clinical parameters useful for spinal pathologies diagnosis and follow-up. Moreover, with an appropriate biomechanical model, the back surface measurements could be used to estimate the spine configuration. The aim of this thesis is to develop and implement such a model based on personalized internal and external data. The Biomod 3S device has been developed by the company AXS MEDICAL SAS, Bordeaux, France. It offers the possibility of simultaneous acquisitions of X-rays and Moiré fringes to obtain 3D reconstructions of the spine and the back surface. Such acquisitions on fifteen scoliotic subjects have enabled us to assess several relationships between internal 3D parameters (for example axial rotation of vertebrae) and external 3D parameters (for example rib hump). The spine configuration and the back surface obtained during this acquisition will also be used as initial position to develop (with Scilab) the multi-body model. The other data used by the model are the back surface in a second position and constraints obtained from the surface in both positions (for example displacement of C7 vertebra). The model has been validated on nine healthy subjects, whose 3D spine and back surface were reconstructed in several positions (standing, leaning forward, sitting) from MRI acquisitions. Moreover, the model has been operated on a pathological subject. This work has explored and utilized many spine and back surface information and leads the way to non-invasive diagnosis and follow-up of spinal disease
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Perrine Koell. Développement d'un modèle biomécanique du rachis basé sur les relations 3D internes – externes : radiographie bi-planaire et franges de Moiré. Médecine humaine et pathologie. Université Claude Bernard - Lyon I, 2010. Français. ⟨NNT : 2010LYO10258⟩. ⟨tel-00577629⟩

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