While recent advances in deep learning have enabled automated Pfirrmann grading systems for intervertebral disc degeneration (IDD), many models remain inaccessible due to proprietary restrictions. This study aimed to develop and validate a convolutional neural network (CNN) for automated Pfirrmann grading using a diverse clinical dataset, to compare our model’s performance with previously published results, and to create an open-source web application with a graphical user interface capable of grading both DICOM studies and individual MRI slices provided as image files. We trained a CNN-based model using the YOLOv8x architecture on two datasets: a well-curated Russian disc degeneration study (RuDDS) cohort and an open-access dataset, totaling 484 lumbar MRI scans. Ground truth grading was provided by expert radiologists. The model was designed to simultaneously detect intervertebral discs and classify degeneration grades from single MRI slices. Performance was evaluated using standard metrics, including precision, recall, and mean average precision (mAP) across Pfirrmann grades I to V. Our model achieved predictive accuracy between 0.78 and 0.82 depending on lumbar level. The highest performance was observed for Grade IV discs (mAP50 = 0.872), while performance for Grade V was lower (mAP50-95 = 0.525), likely due to poor contrast and indistinct boundaries in highly degenerated discs. Overall, the model demonstrated a precision of 0.75 and a recall of 0.808. Comparison with previous studies revealed that our results are consistent with expert-level performance. The developed model formed the basis of a specialized web application, SpineScan, implemented using the Streamlit framework. The developed model shows strong potential for automated grading of lumbar disc degeneration and performs comparably to expert radiologists in most cases. Our findings support the potential applicability of SpineScan for AI-assisted Pfirrmann grading.
Background: The use of bone marrow aspirate concentrate for aseptic bone necrosis can improve patient treatment outcomes, as well as delay or avoid joint replacement. However, the cellular composition of bone marrow concentrate and the results of treatment depend on the method of its preparation, which ultimately affects the outcome of treatment. Aim: To develop a simple and fast method for prepare bone marrow aspirate concentrate to improve the treatment efficiency of patients with early stages of osteonecrosis of the femoral head. Materials and methods: The study included 35patients (64hip joints) with ARCO stage II–IIIA ANGBI. The treatment at the Priorov National Research Medical Center included tunneling using bone marrow aspirate concentrate obtained by the original method. The observation period is 12months. Functional results (HHS, WOMAC), pain (VAS), quality of life (SF-36), stage and activity of ANGBC were evaluated (MRI of both joints ≥1.5Tl before surgery, after 3, 6, 12months; CT before surgery, after 6, 12months). Results: The presented technique provided a significant increase in the number of cells in the bone marrow concentrate after centrifugation compared with native bone marrow. There was a significant improvement in HHS and WOMAC indicators, and a decrease in VAS pain after treatment. Progression from ARCO stage II to IIIA was observed in 4 hip joints (4patients), from ARCO stage IIIA to IIIB in 5hip joints (4patients). The size of the necrotic lesion remained unchanged after 12months in all joints. Total arthroplasty was required in 4 patients (5joints; 7.7% of the total number of joints). Conclusion: The presented method for prepare bone marrow aspirate concentrate allows obtaining the target number of cells that must be introduced into the femoral head to restore the same number of cells as in the normal femoral head. The effectiveness of using bone marrow aspirate concentrate has been proven in the early stage of AVN (IIstage to ARCO), which most of the patients we observed had.
Modern technologies open up prospects for using new effective methods of stimulating reparative osteogenesis in order to optimize patient treatment outcomes. The aim of the study was to present microscopic and biomechanical characteristics of rat diaphysis and femoral bone regeneration formed on the 120th day after surgery and the use of MMSC secretome. The results of experimental study of structural and biomechanical characteristics of rat femoral diaphysis regenerate on the 120th day of reparative osteogenesis after induction of bone defect under the conditions of application of an innovative regenerative preparation - secretome of multipotent mesenchymal stromal cells – are presented. Bone samples in which saline solution was injected into the area of osteorepair, as well as intact rat femurs served as control. The material was studied by light microscopy, microscopic morphometry and biomechanical tests. It was found that in the experimental group the regenerate is compacted, has histotypic features and is formed mainly by lamellar bone tissue. In the control group, the regenerate is thinner than in the experimental group, has no histotypic features, and in its structure, there is a greater representation of reticulofibrous bone tissue compared to the experimental group. Both in the experimental and control groups the remodeling of the regenerate is not completed. Obviously, this affects the strength characteristics of the bone. Biomechanical tests have shown that the femur bones of animals of the experimental and control groups are inferior to intact samples in terms of strength characteristics. At the same time, experimental samples exceed control samples by 25%, which corresponds to the results of morphological studies.
Introduction. Multiple hereditary exostoses (MHE) is a disease that progresses as a child grows, which leads to severe deformities of the skeleton. In 30–60% of MHE cases, the bones of the forearms are affected with the development of radius deformity. In addition to resection of bone and cartilage formations, surgical treatment may include various types of osteotomies using submersible metal fixators and external fixation devices. The development of guided-growth technology dictates the need to expand the scope of minimally invasive surgery. The possibilities of using this technology for deformities of the upper extremities have not yet been sufficiently studied. Objective. To evaluate the effectiveness of the method of controlled bone growth in the surgical treatment of ulnar deformity against the background of multiple hereditary exostoses. Materials and methods. In the period from 2021–2024, thirty three 5 to 17 years children (55 segments/forearms) were hospitalized at the National Medical Research Center for Children’s Health. The study group consisted of 13 children (15 segments) diagnosed with: Distal radius deformiry on the background of multiple hereditary exostoses. A control group of 20 (40 segments) children were diagnosed with juvenile idiopathic arthritis. Patients from the study group underwent surgical treatment of radius deformity using temporary arrest of the growth zone (hemiepiphysiodesis) of the radius. All the studied patients were assessed the angle of the ulnar tilt (UT) and of the lunate subsidence (LS) on X-rays of the forearm in direct projection, patients from the study group were radiographed in the preoperative period and 12–20 months after surgery. The statistical analysis of the studied parameters is based on the search for statistical differences in groups and was performed in the Stattech program. Results. The preoperative value of the elbow angle UT was 35° (33.40), after surgical treatment, UT was 27° (24.32) at p = 0.0002. The value of the LS before surgery was 8.73 ± 3.33 mm, after surgical correction LS was 7.48 ± 3.36 mm at p = 0.005. The achieved level of correction of UT and LS in the study group did not statistically differ from that of the control group, which indicates that the target values were achieved. The average angle of correction of the UT parameter was 8°/year, the trend in postoperative LS values was 1.25 mm/year. Conclusion. The technology of guided-growth effectively corrects the axis of the radius deformity in MHE children during growth. The timely application of this technology makes it possible to prevent the development of severe deformity of the radius and to abandon the performance of corrective osteotomies in the future
Intra articular calcaneus fractures with dislocation of fragments after conservative or inadequate surgical treatment can lead to a serious orthopedic problem. Subtalar arthrodesis is performed after calcaneus fractures, with the development of progressive osteoarthritis. Subtalar distraction bone block arthrodesis is indicate with severe depression of the posterior articular facet, to restore normal relationships of the hind foot.
