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A Kohonen neural network description of scoliosis fused regions and their corresponding Lenke classification

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Surgical instrumentation for adolescent idiopathic scoliosis (AIS) is a complex procedure where selection of the appropriate curve segment to fuse, i.e., fusion region, is a challenging decision in scoliosis surgery. Currently, the Lenke classification model is used for fusion region evaluation and surgical planning. Retrospective evaluation of Lenke classification and fusion region results was performed.

Methods

Using a database of 1,776 surgically treated AIS cases, we investigated a topologically ordered self organizing Kohonen network, trained using Cobb angle measurements, to determine the relationship between the Lenke class and the fusion region selection. Specifically, the purpose was twofold (1) produce two spatially matched maps, one of Lenke classes and the other of fusion regions, and (2) associate these two maps to determine where the Lenke classes correlate with the fused spine regions.

Results

Topologically ordered maps obtained using a multi-center database of surgically treated AIS cases, show that the recommended fusion region agrees with the Lenke class except near boundaries between Lenke map classes. Overall agreement was 88%.

Conclusion

The Lenke classification and fusion region agree in the majority of adolescent idiopathic scoliosis when reviewed retrospectively. The results indicate the need for spinal fixation instrumentation variation associated with the Lenke classification.

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References

  1. Aubin CE, Labelle H, Ciolofan OC (2007) Variability of spinal instrumentation configurations in adolescent idiopathic scoliosis. Eur Spine J 16(1): 57–64

    Article  PubMed  Google Scholar 

  2. Carman DL, Browne RH, Birch JG (1990) Measurement of scoliosis and kyphosis radiographs: intraobserver and interobserver variation. J Bone Joint Surg Am 72: 328–333

    PubMed  CAS  Google Scholar 

  3. Cil A, Pekmezci M, Yazici M (2005) The validity of lenke criteria for defining structural proximal thoracic curves in patients with adolescent idiopathic scoliosis. Spine 30: 2550–2555

    Article  PubMed  Google Scholar 

  4. Duda RO, Hart PE (1973) Pattern Classification and Scene Analysis. Wiley, New York

    Google Scholar 

  5. Duong L, Cheriet F, Labelle H (2006) Three-dimensional classification of spinal deformities using fuzzy clustering. Spine 31(8): 923–930

    Article  PubMed  Google Scholar 

  6. Kohonen T (1995) Self-organizing maps. Springer, Berlin

    Book  Google Scholar 

  7. LeBail E, Mitiche A (1989) Quantification vectorielle d’images par le rèseau neuronal de kohonen. Traitement du Signal 6(6): 529–539

    Google Scholar 

  8. Lenke L (2007) The lenke classification system of operative adolescent idiopathic scoliosis. Neurosurg Clin N Am 18(2): 199–206

    Article  PubMed  Google Scholar 

  9. Lenke LG, Betz RR, Bridwell KH, Clements DH, Harms J, Lowe TG, Shufflebarger HL (1998) Intraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis. J Bone Joint Surg Am 80: 1097–1106

    PubMed  CAS  Google Scholar 

  10. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83: 1169–1181

    PubMed  Google Scholar 

  11. Lenke LG, Betz RR, Clements D, Merola A, Haher T, Lowe T, Newton P, Bridwell KH, Blanke K (2002) Curve prevalence of a new classification of operative adolescent idiopathic scoliosis. Spine 27(6): 604–611

    Article  PubMed  Google Scholar 

  12. Lippman R (1987) An introduction to computing with neural networks. IEEE ASSP Mag 3: 4–22

    Article  Google Scholar 

  13. Loder RT, Urquhart A, Sten H (1995) Variability in cobb angle measurements in children with congenital scoliosis. J Bone Joint Surg Am 77: 768–770

    CAS  Google Scholar 

  14. Lowe TG, Alongi PR, Smith DAB (2003) Anterior single rod instrumentation for thoracolumbar adolescent idiopathic scoliosis with and without the use of structural interbody support. Spine 28: 208–216

    Article  Google Scholar 

  15. Lowe TG, Alongi PR, Smith DAB (2003) Anterior single rod instrumentation for thoracolumbar adolescent idiopathic scoliosis with and without the use of structural interbody support. Spine 28: 2232–2241

    Article  PubMed  Google Scholar 

  16. Mezghani N, Chav R, Humbert L, Parent S, Skalli W, de Guise JA (2008) A computer-based classifier of three dimensional spinal scoliosis severity. Int J Comput Assist Radiol Surg 3(1–2): 55–60

    Article  Google Scholar 

  17. Mezghani N, Cheriet M, Mitiche A (2003) Combination of pruned kohonen maps for on-line Arabic characters recognition. In: Seventh international conference on document analysis and recognition, vol 2, Edinburgh. pp 900–905

  18. Mitiche A, Aggarwal JK (1996) Pattern category assignement by neural networks and the nearest neighbors rule. Int J Pattern Recog Artif Intell 10: 393–408

    Article  Google Scholar 

  19. Oja M, Kaski S, Kohonen T (2003) Bibliography of self-organizing map SOM papers: 1998–2001 addendum. Neural Comput Surv 3: 1–156

    Google Scholar 

  20. Phan P, Labelle H, Ouellet J, Mezghani N, de Guise JA (2011) The use of a decision tree based on the literature can efficiently output the levels of fusion alternatives in the surgical treatment of ais. In: Canadian spine society annual meeting

  21. Ritter H, Schulten K (1988) Kohonen’s self-organizing maps: exploring their computational capabilities. In: IEEE international joint conference on neural networks, pp 109–116, San Diego

  22. Robitaille M, Aubin CE, Labelle H (2007) Intra and interobserver variability of preoperative planning for surgical instrumentation in adolescent idiopathic scoliosis. Eur Spine J 16(10): 1604–1614

    Article  PubMed  CAS  Google Scholar 

  23. Sabourin M, Mitiche A (1993) Modeling and classification of shape using a Kohonen associative memory with selective multiresolution. Neural Netw 6(2): 275–283

    Article  Google Scholar 

  24. Stokes IA, Sangole AP, Aubin CE (2009) Classification of scoliosis deformity three-dimensional spinal shape by cluster analysis. Spine 34(6): 584–590

    Article  PubMed  Google Scholar 

  25. Su M, Chang H, Chou C (2002) A novel measure for quantifying the topology preservation of self-organizing feature maps. Neural Process Lett 15: 137–145

    Article  Google Scholar 

  26. Tso B, Mather PM (2009) Classification methods for remotely sensed data. 2nd edn. CRC Press, New York

    Book  Google Scholar 

  27. Uriarte E, Martín F (2005) Topology preservation in som. Int J Appl Math Comput Sci 1: 19–22

    Google Scholar 

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Mezghani, N., Phan, P., Mitiche, A. et al. A Kohonen neural network description of scoliosis fused regions and their corresponding Lenke classification. Int J CARS 7, 257–264 (2012). https://doi.org/10.1007/s11548-011-0667-0

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  • DOI: https://doi.org/10.1007/s11548-011-0667-0

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