Artist Cole Blaq's model of a spine, called Tuff to the Bones (above), is meant to depict "anatomy and the perception of genetic science from a view of a simple person," he wrote in an e-mail.
The title could also imply resilience.
Scientists who study back pain must have plenty of that because studying back pain is well ... a pain. It's complicated and experts haven't quite figured out what causes it.
But William Marras, the director of Ohio State University's Biodynamics Laboratory, is developing a personalized, "dynamic MRI," which images how human spines move and react in different scenarios like lifting a box, pushing a cart, twisting or bending. The model is based on measurements taken from individual patients as they move.
The technology could help researchers understand the root causes of back pain, which afflicts up to 80 percent of people at least once in their lives.
Marras and his staff measure the patient's body. They stick electrodes on the patient's torso and place a motion-sensitive device around their lower back. They put markers on a patient's joints to figure out how their arms and legs move. When a patient walks or raises his arms, electrodes and sensors record those movements.
The researchers also use MRIs and CT scans to give them an accurate picture of the patient's tissues and bones. They integrate all the data and construct a 3-dimensional model of the spine. The model can give them insights into how specific or repetitive movements cause muscle stress. They can then use that information to advice companies on how to design their workplace to minimize injury or surgeons on the best course of treatment for patients.
Some of Marras' research is focused on preventing work-related injuries in the car industry, so he brings workers into the lab, where they can simulate the production process with cars and tools they'd have at the factory. If he's assessing a patient considering surgery, he'll have him perform everyday activities like bending, twisting and lifting. Marras and his staff also get feedback from the patient about how he/she is feeling. Researchers who use cadaver spines or computer-based models don't get that information.
Personalized spine modeling could increase the success rates for spinal surgery, which tends to leave patients "no better or worse" in 50 percent of cases, Marras says.
"You can make all your mistakes on a computer before going and trying it out on a person," he said.
For years, researchers have studied back pain generally, asking patients if they're doing too much heavy lifting, whether back pain runs in their family, or if they're sitting in front of a computer for too long, Marras says. They've relied on computer models or cadaver spines to study how the spine reacts to stress and pressure.
These models can simulate daily activities, provided researchers know what muscles are involved, says David Moody, who developed a spine simulator as part of a collaboration at the University of California, Berkeley and the University of California, San Francisco to test how muscle strain and posture contribute to back pain. The problem is that researchers often lack this information.
Plus, "movement is the key to life," Marras said. "A lot of these models that are out there don't really assess what happens when people move," which could be a recipe for misunderstanding what's really happening, he said.
Despite its benefits, there's still a long way to go before Marras' system is widely available. He didn't say how much the procedure cost, but he did say it wasn't cheap. Plus, the modeling takes three to four people about a month to complete. He hopes he'll be able to cut that time down significantly over the next few years so the technique can be used more routinely.
Until then, the recommendations he's able to make are still based on generalizations based on a few people's personalized scans, in a way that's similar -- though in Marras' opinion superior -- to working with a robotic setup and cadaver spines, which are a scarce resource. The end goal of both approaches, however, is the same: to design personalized treatments.
"If I can make detailed models of a handful of people and say, 'Ah ha!' When people do this, this is what happens to the spine, then I can find more general ways to fit that in to a much larger population and come up with much stronger relationships. You'll know what you're talking about as opposed to just having fuzzy ideas as to what the cause and effect is," Marras said.
Image: Tuff to the Bone by Cole Blaq. Cole Blaq / Flickr.