Doctors everywhere are being asked to screen patients with back problems more carefully when they’re referred for MRI scans. A new diagnostic technology under development at the University of Alberta may reduce demand for MRI scans by offering an alternative approach that has potential to better pinpoint dysfunctions of the spine and other joints. Called vibration imaging, the technology is similar to the seismic imaging used in the petrochemical industry to detect pockets of oil deep below ground. To develop and commercialize the technology, the VibeDx Diagnostic Corp was launched in Edmonton.
Greg Kawchuk (pictured), a professor with the Faculty of Rehabilitation Medicine at the University of Alberta and lead researcher at VibeDx, says: “We did some proof-of-concept testing in cadaver models, and we were able to show that you can use vibration on both hard and soft tissue to not only identify if there’s a problem, but also where it is, what kind of problem, and the magnitude.”
The team also conducted a unique identical twin study which was published in the March 2016 issue of the online journal Scientific Reports. The study found that in the instances where twins had similar spines, the vibration responses were statistically similar. But in cases where one twin had a different spine due to accident or injury, the vibration responses were significantly different from their siblings. “One of the key reasons we selected this technology to go forward is because it’s highly sensitive to minute changes,” says Kawchuk.
While the technology has been shown to be effective at identifying anomalies in both soft and hard tissue, Kawchuk believes VibeDx can be more usefully employed in detecting musculo-skeletal problems. “There are already some pretty good laboratory tests to assess liver or other organ functions. However, there are almost no tests for musculo-skeletal systems, especially in the spine, for assessing or quantifying function – there are just no hard numbers.”
Even MRI scans often can’t give precise measurements of musculo-skeletal functions simply because patients are forced to lie down and remain still while the scan is done, he adds. VibeDx may be better than MRI for this area because it detects anomalies during small motions created during vibration. “There have been improvements in this area by introducing upright MRIs into the market to measure joint functions while subjects are weight-bearing. But even with these, many issues aren’t caught because things change when people move around.”
At present, MRIs can only detect the source of back pain in a very small percentage of patients. For the vast majority of patients, MRIs detect no anomalies and provide no direction at all to zero in on the source of dysfunction. Patients are typically advised to exercise more but there are a bewildering number of exercise modalities – yoga, pilates, isometric, and so on – all purporting to alleviate back pain.
“There isn’t any diagnostic available now that gives good objective information for musculo-skeletal conditions like back pain. If we had better diagnostics, then we could do a much better job of finding really effective treatment programs targeting specific musculo-skeletal conditions.”
If VibeDx could detect, say, the 15 percent of patients who had the same back dysfunction, that would be a big win, says Kawchuk. “If we could identify specific categories or spine problems in an objective way, then we could zero in and work out exactly what interventions should be done at what specific frequency to resolve the issue – instead of giving patients generic advice.”
It would also be a big win for the healthcare system, as many patients with back problems could be removed from MRI queues. “If we could pick out the 15% of people with back pain that have a certain vibrational fingerprint that we know responds to a specific intervention, then we can take them out of the equation. That’s what I think the future promise for VibeDx is – it’ll help us screen patients who are in the queue for MRI. If they’re coming up normal on vibration technology, maybe they don’t have to wait for an MRI only to be told that they’re not a candidate for a specific intervention like surgery.”
The cost of back pain is enormous, and it’s important to find diagnostics and remedies that actually work “The Bill and Melinda Gates Foundation identifies back problems as the number 1 cause of disability worldwide. Back pain is really a collection of different problems, like cancer. And we’ve gone about it wrong in the past, trying to find one remedy that will work for all back pain. ”
Kawchuk says his team is planning another clinical trial this year to get more evidence to commercialize vibration technology and get Health Canada and FDA approval. “The next stage is to do a bigger clinical trial that will put the technology into various clinical and diagnostic situations and see how it performs.”
The response from the medical community to vibration technology has been very positive, says Kawchuk. “We’re getting a lot of interest from healthcare providers who want to know if and when this new diagnostic will be available. There’s a huge need out there for a better tool to diagnose specific back problems.”
For more information, visit http://www.vibedx.com/