#Lateral view of cervical spine x ray manual#

In recent years, digital viewer measurements became more common 5, but surgeons generally still had to obtain measurements manually. Historically, such measurements have been obtained by using a protractor on radiographs. Measuring cervical alignment in multiple positions is important in evaluating pathology and planning surgery 4. Similar content being viewed by othersĬervical alignment, an important clinical parameter in spine disorders, is associated with deformity, myelopathy, adjacent-segment disease, horizontal gaze, and health-related quality of life 1, 2, 3. However, because of the large errors in rare cases such as highly deformed ones, AI may, in principle, be limited to assisting humans. AI can assist in routine medical care and can be helpful in research that measures large numbers of images. The AI model measured cervical spine alignment with better accuracy than surgeons. The AI model had a significantly smaller error than Surgeon 1 and Surgeon 2 (P = 0.002 and 0.036). For comparison of other surgeons, the mean absolute error for measurement of 168 patients was 3.1° ± 3.4° for the AI model, 3.9° ± 3.4° for Surgeon 1, and 3.8° ± 4.7° for Surgeon 2. In fivefold cross-validation, the absolute error of the AI model was 3.3° in the average and 2.2° in the median. Additionally, the absolute error of AI measurements was compared with the error of other 2 surgeons’ measurements on 415 radiographs of 168 randomly selected patients. The absolute error of the AI measurements relative to the ground truth for 4546 x-rays was determined by fivefold cross-validation. This ground truth was split into training data and test data, and the AI model learned the training data. For all x-rays, the caudal endplates of C2 and C7 were labeled based on consensus among well-experienced spine surgeons, the data for which were used as ground truth.

We included 4546 cervical x-rays from 1674 patients.

This study aimed to develop AI for automated measurement of lordosis on lateral cervical x-rays. Artificial intelligence (AI) in the form of convolutional neural networks has begun to be used to measure x-rays.

#Lateral view of cervical spine x ray manual#

Manual measurement is time-consuming and burdensome to measurers. Cervical sagittal alignment is an essential parameter for the evaluation of spine disorders.