Juni 2016 – iTEC Engineering Support für die Sternklinik in Bremen im medizinischen Bereich mit der Entwicklung eines SW-Systems zur Phenotypisierung Lumbar Spine

Dr. J. Assheuer, Dr. F Balaque & Dr. F. Forutan
Dipl.-Inf. R. Reisener & Dipl. Ing. W. Kaufmann

Sources by Sternklinik Bremen, Veritas Healths LLC & iTEC Engineering – Page under Construction

Introduction
Phenotypisation of the lumbar disks degenerative lesions was the topic of last 4 meetings of the ISSLS focus group on disc degeneration.
In 2014 the focus was enlarged to the whole lumbar spine degeneration.
No consensus exists for denitions of dierent degenerative diseases nor for classication of these diseases.
The existing scoring systems are usually limited to a single structure e.g. disc, facets, spinal canal, etc

Purpose
The aim of this study is to present a simple method to describe the normal and global radiological changes
of the lumbar spine and by that to get a tool for classication.

Method
Our tool is derived from the TNM classication system used for tumors. It includes 10 main categories and for
each one up to 4 levels of modiers. The ndings were encoded in a standardized manner summarized in table 1.

Results
In a rst trial 200 MR examinations of consecutive patients of dierent age and gender referred to MRI for
lumbar spine examination were encoded. The mean time for coding was 3 minutes. Examples of correlations
were done with respect to age and gender..There was strong correlation of disc degeneration with age not
with gender. There was no dierence in the frequency of protrusion and extrusion in the categories of age
and gender. The number of phenotypes done by algorithm is depending on the number of characteristics
introduced in the system.

Conclusion
The presented proposal for phenotypisation of changes of the lumbar spine seems to be a valuable tool to
describe these changes and allow to form groups of phenotypes. It can be the base to compare groups and
subgroups and to allow correlations within the groups and subgroups. The system can easily be extended
with additional characteristics.
It allows better comparison of dierent studies of the lumbar spine

Bold gures means the code for categories and modiers.
In the same way other main categories like Disc Height, End plate Changes, Neuroforaminal
Stenosis, Deformities are to be encoded.
Example for encoding: male patient in 3rd decennium spinal narrowing by herniation with extrusion
in L5/S1 in central position.
A,3;G,M; I ,H,E, V,C