1
|
Malinda V, Lee D. Lumbar Vertebrae Synthetic Segmentation in Computed Tomography Images Using Hybrid Deep Generative Adversarial Networks. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1327-1330. [PMID: 33018233 DOI: 10.1109/embc44109.2020.9175791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The lumbar vertebrae segmentation in Computed tomography (CT) is challenging due to the scarcity of the labeled training data that we define as paired training data for the deep learning technique. Much of the available data is limited to the raw CT scans, unlabeled by radiologists. To handle the scarcity of labeled data, we utilized a hybrid training system by combining paired and unpaired training data and construct a hybrid deep segmentation generative adversarial network (Hybrid-SegGAN). We develop a total automatic approach for lumbar vertebrae segmentation in CT images using Hybrid-SegGAN for synthetic segmentation. Our network receives paired and unpaired data, discriminates between the two sets of data, and processes each through separate phases. We used CT images from 120 patients to demonstrate the performance of the proposed method and extensively evaluate the segmentation results against their ground truth by using 12 performance measures. The result analysis of the proposed method suggests its feasibility to improve the capabilities of deep learning segmentation without demanding the time-consuming annotation procedure for labeled and paired data.
Collapse
|
2
|
Pavelka K, Jarosova H, Sleglova O, Svobodova R, Votavova M, Milani L, Prochazka Z, Kotlarova L, Kostiuk P, Sliva J, Meroni AM. Chronic Low Back Pain: Current Pharmacotherapeutic Therapies and a New Biological Approach. Curr Med Chem 2019; 26:1019-1026. [PMID: 29756567 DOI: 10.2174/0929867325666180514102146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 07/05/2017] [Accepted: 04/25/2018] [Indexed: 11/22/2022]
Abstract
Chronic low back pain (CLBP) syndrome represents one of the leading causes of long-term disability worldwide. The prevalence of CLBP has been rising significantly in relation to increasing average life expectancy. CLBP results from chronification of acute low back pain. There are many factors contributing to the CLBP crisis; common etiopathogenetic factors include e.g., functional blockage of intervertebral joints. The treatment of CLBP is complex. An important part of treatment consists of pain pharmacotherapy, for which several groups of drugs are used. The problem lies in the side effects of many of these traditionally used medications. Therefore, new and safer treatment methods are being sought. Innovative options for CLBP pharmacology include injections containing collagen, which can be combined with other traditionally used drugs, which helps reduce dosages and increase the overall safety of CLBP therapy.
Collapse
Affiliation(s)
- K Pavelka
- Institute of Rheumatology, Prague, Czech Republic
| | - H Jarosova
- Institute of Rheumatology, Prague, Czech Republic
| | - O Sleglova
- Institute of Rheumatology, Prague, Czech Republic
| | - R Svobodova
- Institute of Rheumatology, Prague, Czech Republic
| | - M Votavova
- Institute of Rheumatology, Prague, Czech Republic
| | - L Milani
- University Sapienza, Rome and University of Siena, Italy
| | | | | | | | - J Sliva
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - A M Meroni
- Department of Orthopedics and Traumatology, Niguarda Hospital, Milano, Italy
| |
Collapse
|
3
|
Wong AYL, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. SCOLIOSIS AND SPINAL DISORDERS 2017; 12:14. [PMID: 28435906 PMCID: PMC5395891 DOI: 10.1186/s13013-017-0121-3] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/04/2017] [Indexed: 12/12/2022]
Abstract
Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions. Existing evidence suggests that prevalence rates of severe and chronic LBP increase with older age. As compared to working-age adults, older adults are more likely to develop certain LBP pathologies (e.g., osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis). Importantly, various age-related physical, psychological, and mental changes (e.g., spinal degeneration, comorbidities, physical inactivity, age-related changes in central pain processing, and dementia), as well as multiple risk factors (e.g., genetic, gender, and ethnicity), may affect the prognosis and management of LBP in older adults. Collectively, by understanding the impacts of various factors on the assessment and treatment of older adults with LBP, both clinicians and researchers can work toward the direction of more cost-effective and personalized LBP management for older people.
Collapse
Affiliation(s)
- Arnold YL Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR China
| | - Jaro Karppinen
- Medical Research Center Oulu, Department of Physical and Rehabilitation Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
- Finnish Institute of Occupational Health, Oulu, Finland
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR China
| |
Collapse
|
4
|
Caneiro JP, Smith A, O'Sullivan K, O'Keeffe M, Dankaerts W, Fersum K, Gibson W, Wand BM, O'Sullivan P. RE: "Low back pain misdiagnosis or missed diagnosis: Core principles" (Monie AP, Fazey PJ, Singer KP. Manual Therapy 22 (2016) 68-71). Musculoskelet Sci Pract 2017; 28:e1-e2. [PMID: 27720322 DOI: 10.1016/j.math.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 10/21/2022]
Affiliation(s)
- J P Caneiro
- School of Physiotherapy & Exercise Science, Curtin University, Perth, Australia; Body Logic Physiotherapy Clinic, Perth, Australia.
| | - Anne Smith
- School of Physiotherapy & Exercise Science, Curtin University, Perth, Australia
| | - Kieran O'Sullivan
- Sports Spine Centre, Qatar Orthopaedic and Sports Medicine Hospital, Aspetar, Qatar
| | - Mary O'Keeffe
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Wim Dankaerts
- Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Belgium
| | - Kjartan Fersum
- Physiotherapy Research Group, Department of Public Health and Primary Health Care, University of Bergen, Norway
| | - William Gibson
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia
| | - Peter O'Sullivan
- School of Physiotherapy & Exercise Science, Curtin University, Perth, Australia; Body Logic Physiotherapy Clinic, Perth, Australia
| |
Collapse
|
5
|
Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, Baciarello M, Manferdini ME, Fanelli G. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res 2016; 5. [PMID: 27408698 DOI: 10.12688/f1000research.8105.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2016] [Indexed: 12/12/2022] Open
Abstract
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making. Answering the question "what is the pain generator" among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet Joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.
Collapse
Affiliation(s)
- Massimo Allegri
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Silvana Montella
- Department of Surgical Sciences, University of Parma, Parma, Italy
| | - Fabiana Salici
- Department of Surgical Sciences, University of Parma, Parma, Italy
| | - Adriana Valente
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Maurizio Marchesini
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Christian Compagnone
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Marco Baciarello
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Maria Elena Manferdini
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Guido Fanelli
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| |
Collapse
|
6
|
Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, Baciarello M, Manferdini ME, Fanelli G. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res 2016; 5. [PMID: 27408698 PMCID: PMC4926733 DOI: 10.12688/f1000research.8105.2] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 12/19/2022] Open
Abstract
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making. Answering the question "what is the pain generator" among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet Joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.
Collapse
Affiliation(s)
- Massimo Allegri
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Silvana Montella
- Department of Surgical Sciences, University of Parma, Parma, Italy
| | - Fabiana Salici
- Department of Surgical Sciences, University of Parma, Parma, Italy
| | - Adriana Valente
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Maurizio Marchesini
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Christian Compagnone
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Marco Baciarello
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Maria Elena Manferdini
- Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| | - Guido Fanelli
- Department of Surgical Sciences, University of Parma, Parma, Italy; Anaesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliera Universitaria Parma Hospital, Parma, Italy
| |
Collapse
|