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A Digital Photogrammetric Method to Enhance the Fabrication of Custom-Made Spinal Orthoses

Grazioso, Stanislao, PhD; Selvaggio, Mario, MD; Caporaso, Teodorico, MD; Di Gironimo, Giuseppe, PhD

JPO: Journal of Prosthetics and Orthotics: April 2019 - Volume 31 - Issue 2 - p 133–139
doi: 10.1097/JPO.0000000000000244
TECHNICAL NOTE
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Introduction and Objectives Fabrication processes for spinal orthoses require accurate three-dimensional (3D) models of the patients' trunk. Current methods for 3D reconstruction used in this field mainly include laser or structured light scanning; these methods are time expensive and invasive, especially for patients with partial disabilities. Therefore, a theoretically instant system for data acquisition of anatomical structure is highly desirable. The objective of this work is to show the feasibility of using digital photogrammetry for human body digitization to generate accurate 3D models of the patients' trunk for spinal orthoses fabrication.

Materials and Methods Multiple synchronized two-dimensional images of the human torso are captured from different points of view using a photogrammetric scanner. A 3D model is generated using the state-of-the-art algorithms for point cloud and surface reconstruction. The digitized model is then used as input for the standard computer-aided design (CAD)/computer-aided manufacturing (CAM) process of fabrication. R4D from Rodin4D is used as prosthetics and orthotics CAD software. A robotic cell constituted by a six-axis KUKA KR 30–3 is used for milling a polyurethane foam. Vacuum forming is then adopted to generate the orthosis. Two spinal orthoses are fabricated using this approach and a classical one; then, they are evaluated using quantitative and qualitative metrics.

Results The data acquisition using this approach lasts 50 milliseconds. The 3D reconstruction accuracy averages 0.21 ± 1.27 mm, which suits for the considered health care scenario. Results of the initial fitting of the orthoses fabricated with the presented method show better performances in terms of time (44%), product quality (35%), and patient experience (30%).

Conclusions Digital photogrammetry can be used to enhance the data acquisition and data processing of anatomical surfaces for the CAD/CAM process of spinal orthoses. The data acquisition time, almost instant, allows an easy compliance of many patients. The data processing allows generating accurate models of the patient's body. The overall process generates orthoses with a better quality with respect to those manufactured using conventional procedures.

STANISLAO GRAZIOSO, PhD; TEODORICO CAPORASO, MD; and GIUSEPPE DI GIRONIMO, PhD, are affiliated with the Department of Industrial Engineering, University of Naples Federico II, Napoli, Italy.

MARIO SELVAGGIO, MD, is affiliated with the Department of Information Technology and Electrical Engineering, University of Naples Federico II, Napoli, Italy.

Disclosure: The authors declare no conflict of interest.

Correspondence to: Stanislao Grazioso, Department of Industrial Engineering, University of Naples Federico II, 80125 Napoli, Italy; email: stanislao.grazioso@unina.it

© 2019 by the American Academy of Orthotists and Prosthetists.