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Investigating Fryette Mechanics in CT Scans

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 35-36. doi: Subito , type of study: retrospective study

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

3D models [1]
computed tomography [7]
Fryette mechanics [1]
lumbar spine [43]
retrospective study [213]
spinal motion [2]
thoracic spine [56]

Abstract:

Introduction/Background: Fryette mechanics is an integral part of osteopathic practice, adopted in many guiding branches of study as an accepted scientific principle of coupled spinal movement. Its validity has long been contested in practice, highlighting the need for continued experimentation. This research combines innovative advances in technology with the concept of Fryette mechanics, to test its efficacy in predicting spinal movements. Objective: To investigate the presence of coupled spinal movements as described in Fryette mechanics by extracting three-dimensional symmetry planes from diagnostic computed tomography scans of thoracic and lumbar vertebrae. Methods: 953 thoracic and lumbar vertebrae were extracted from three-dimensional models, obtained from 82 computed tomography scans within the VERSE’20 open-source dataset. A stepwise algorithm was used for each vertebra to generate three planes of unique symmetry, which provided three-dimensional angular orientation with respect to the vertebral level below. Data was analyzed to determine quantitative coupled motion, comparing observed spinal movements against expected coupled spinal movements in line with Fryette mechanics. Results: 531 of 953 extracted vertebrae were analyzed; the remaining were omitted secondary to pathology or incongruent symmetry plane analysis. 302 vertebral levels demonstrated coupled physiologic spinal motion consistent with both Type I (166) and Type II (136)Fryette Mechanics. Discussion/Conclusion: The presence of Type I and Type II Fryette mechanics was appreciated in 56.9% of vertebral levels. Although technological advancements allowed the novel application of open-sourced diagnostic imaging to be applied to historically evolving guiding osteopathic principles, they demonstrated the complexity of physiologic spinal motion as influenced by pathology, imaging metrics, and statistical significance. This research highlights the need to further explore osteopathic practice and the philosophy of science, reflecting the union of modern imaging advances with osteopathic theories.


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