Best of Both Worlds: How OSMIA uses quality of spine motion and imaging to get results.
Posted on Tuesday August 1 2017 by Ryan Grimshaw
Most back pain does not have a single specific cause that a clinician can point to and say “there, that is where your pain is coming from".
For the majority of cases where no pathological or neurological cause is identifiable, the pain source is classified as a ‘non-specific’. However, since a great deal of these ‘non-specific’ low back pain cases are made better or worse by movement or position, they can be thought of as being mechanical in nature.
The Center for Biomechanics Research, based at the AECC, asks the question, “If the mechanics of the spine is linked to the cause or symptoms of non-specific low back pain, then surely the mechanics of the spine should be considered in assessments”
Current techniques use imaging to quantify the movement of the spine; either measuring the differences in position between static images or reviewing videos subjectively to assess the quality of spine movement. Static images will only supply the amount of motion between two views, and the viewing of dynamic videos by specialists can only provide subjective assessments of the movement. Other methods include surface motion capture measures the movement at the level of the patient’s skin but not the spine itself.
OSMIA (an Objective Spinal Motion Imaging Assessment) is a diagnostic tool designed to measure the mechanics of the spine in living subjects, in order to better understand how common chronic spinal pain syndromes and biomechanics relate.
OSMIA measures spine motion of individual subjects at the joint level. This is done by using digital fluoroscopy and image processing to give continuous inter-joint motion data as the person bends, either actively or passively.
Reports are generated on a patient-by-patient basis to referring clinicians, providing both numerical and graphical information. Referrers are not limited to chiropractors, many of our referrals are from physiotherapists and spinal surgeons who wish to find out if specific joints are unstable.
What Next for OSMIA?
Our research has become so successful that we have partnered with a medical device company based in Austin, Texas (Orthokinematics.com) to which we have leased the world commercial rights to this technology. Our system remains the original and only device of its level of sophistication in Europe.
Our work does not stop there! One of our main focuses is discovering what ‘normal’ motion of the spine is, because since no one has had access to the level of detail that OSMIA provides before now, it has not been possible to define ‘normal’, or asymptomatic spine movement, in real time. Other investigations have included…
Dr. Fiona Mellor, “An Evaluation of passive recumbent quantitative fluoroscopy to measure mid-lumber intervertebral motion in patients with chronic non-specific low back pain and healthy volunteers.”
Dr. Jonny Branney, “An Observational study of changes in cervical inter-vertebral motion and the relationship with patient-reported outcomes in patients undergoing spinal manipulative therapy for neck pain.”
Dr. Alexander Breen, “A quantitative fluoroscopic study of the relationship between lumbar inter-vertebral and residual limb/socket kinematics in the coronal plane in adult male unilateral amputees. (Exploring the spine and lower limb kinematics of trans-tibial amputees).”
Dr. Alister Du Rose, “Relationships between lumbar inter-vertebral kinematics and paraspinal myoelectric activity during sagittal flexion: a quantitative fluoroscopy and surface electromyography study.”