Spatiotemporal Manifold Prediction Model for Anterior Vertebral Body Growth Modulation Surgery in Idiopathic Scoliosis

Anterior Vertebral Body Growth Modulation (AVBGM) is a minimally invasive surgical technique that gradually corrects spine deformities while preserving lumbar motion. However the selection of potential surgical patients is currently based on clinical judgment and would be facilitated by the identification of patients responding to AVBGM prior to surgery. We introduce a statistical framework for predicting the surgical outcomes following AVBGM in adolescents with idiopathic scoliosis. A discriminant manifold is first constructed to maximize the separation between responsive and non-responsive groups of patients treated with AVBGM for scoliosis. The model then uses subject-specific correction trajectories based on articulated transformations in order to map spine correction profiles to a group-average piecewise-geodesic path. Spine correction trajectories are described in a piecewise-geodesic fashion to account for varying times at follow-up exams, regressing the curve via a quadratic optimization process. To predict the evolution of correction, a baseline reconstruction is projected onto the manifold, from which a spatiotemporal regression model is built from parallel transport curves inferred from neighboring exemplars. The model was trained on 438 reconstructions and tested on 56 subjects using 3D spine reconstructions from follow-up exams, with the probabilistic framework yielding accurate results with differences of 2.1 +/- 0.6deg in main curve angulation, and generating models similar to biomechanical simulations.

3D Morphology Prediction of Progressive Spinal Deformities from Probabilistic Modeling of Discriminant Manifolds

We introduce a novel approach for predicting the progression of adolescent idiopathic scoliosis from 3D spine models reconstructed from biplanar X-ray images. Recent progress in machine learning have allowed to improve classification and prognosis rates, but lack a probabilistic framework to measure uncertainty in the data. We propose a discriminative probabilistic manifold embedding where locally linear mappings transform data points from high-dimensional space to corresponding low-dimensional coordinates. A discriminant adjacency matrix is constructed to maximize the separation between progressive and non-progressive groups of patients diagnosed with scoliosis, while minimizing the distance in latent variables belonging to the same class. To predict the evolution of deformation, a baseline reconstruction is projected onto the manifold, from which a spatiotemporal regression model is built from parallel transport curves inferred from neighboring exemplars. Rate of progression is modulated from the spine flexibility and curve magnitude of the 3D spine deformation. The method was tested on 745 reconstructions from 133 subjects using longitudinal 3D reconstructions of the spine, with results demonstrating the discriminatory framework can identify between progressive and non-progressive of scoliotic patients with a classification rate of 81% and prediction differences of 2.1$^{o}$ in main curve angulation, outperforming other manifold learning methods. Our method achieved a higher prediction accuracy and improved the modeling of spatiotemporal morphological changes in highly deformed spines compared to other learning methods.