Minimizing errors associated with calculating the location of the helical axis for spinal motions

One of the more common comparative tools used to quantify the motion of the vertebral joint is the orientation and position of the (finite) helical axis of motion as well as the amount of translation along, and rotation about, this axis. A survey of recent studies that utilize the helical axis of motion to compare motion before and after total disc replacement reveals a lack of concern for the relative errors associated with this metric. Indeed, intrinsic algorithmic and experimental errors that arise when interpreting motion tracking data can easily lead to a misinterpretation of the changes caused by replacement disc devices. While previous studies examining these errors exist, most have overlooked the errors associated with the determination of the location of the helical axis and its intersection with a chosen plane. The purpose of the study presented in this paper was to evaluate the sensitivity and reliability of the helical axis of motion as a comparative tool for kinematically evaluating spinal prostheses devices. To this end, we simulated a typical spine biomechanics testing experiment to investigate the accuracy of calculating the helical axis and its associated parameters using several popular algorithms. The resultant data motivated the development of a new algorithm that is a hybrid of two existing algorithms. The improved accuracy of this hybrid method made it possible to quantify some of the changes to the kinematics of a spinal unit that are induced by distinct placements of a total disc replacement.