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Sažetak: Ugradnja totalne endoproteze kolena predstavlja jednu od najčešćih elektivnih operacija u ortopedskoj hirurgiji. Bez obzira na to, i dalje su aktuelne nesuglasice u smislu ograničenosti restitucije obima pokreta nakon artroplastike kolena kao i procenta nezadovoljstva pacijenata. Cilj: Cilj disertacije predstavlja definisanje uspešnosti hirurške operacije kroz analizu hoda operisanih bolesnika u smislu vraćanja obima pokreta zgloba kolena i normalizacije hoda, kao i da na osnovu analize hoda nakon bilateralne artroplastike hoda ukaže da li postoji razlika u obrascu hoda u zavisnosti od dizajna ugrađene endoproteze. Materijal i metodi: U ispitivanju je učestvovalo 78 pacijenta koji su imali osteoartozu jednog kolena, koje je bilo operisano (artroplastika kolena) a drugo koleno je bilo zdravo i 35 pacijenata kod kojih je urađena bilateralna artroplastika kolena različitih dizajna endoproteze. Podaci su zabeleženi korišćenjem komercijalnog OptiTrack sistema za snimanje kretanja sa šest infracrvenih kamera. Markeri su postavljani na donje ekstremitete pacijenata, i to u tačno određenim anatomskim regionima. Nakon izvršenog snimanja, podataci su obrađeni korišćenjem programskog okruženja MATLAB. Rezultati: Merenjem smo dobili veoma izraženu redukciju u pokretima kod obolelih kolena u odnosu na zdrava. Nakon ugradnje proteze kolena, obim pokreta se povećava i vrednosti se približavaju vrednostima koje su izmerena na zdravom kolenu. Rezultatima je pokazan veći stepen fleksije kod PS u odnosu na CR proteze. Takođe, rezultati pokazuju zanemarljive vrednosti ML translacije, lateralnog međuprostora i medijalnog međuprostora kod oba tipa proteza. Zaključak: U rezultatima smo pokazali da postoji jasna razlika u obrascu kretanja kod pacijenata sa gonartrozom pre i posle ugradnje endoproteze i da se ta razlika uspešno i brzo može utvrditi uz pomoć OptiTrack sistema. Pored toga dokazano je da artroplastika kolena dovodi do normalizacije hoda, ali bez statistički značajne razlike u obimu pokreta nakon ugradnje PS i CR endoproteze kolena. Abstract: Introduction: Implantation of a total knee endoprosthesis represents one of the most common elective procedures in orthopedic surgery. Nevertheless, debate exists regarding the limitations in restoring the motion range after knee arthroplasty and the levels of patiets dissatisfaction. Aim: The aim of this dissertation is to define success of surgery using gait analysis of patients regarding the restoration of the motion range of the knee joint and of normal walking. It also aims to point to the presence of the difference in the gait patterns depending on the design of the implanted endoprothesis and based on the gait analysis after the implantation of bilateral arthroplasty. Materials and Methods: 78 patients with knee osteoarthrosis were examined; total knee arthroplasty was implanted in the patients’ affected knee whereas the other knee was in a healthy state. Bilateral knee arthroplasty was implanted in 35 patients including various endoprosthesis designs. The data was collected with the commercial OptiTrack system for motion detection using six infrared cameras. The markers were placed on the exact anatomical positions of the lower extremities. After recording, the data was processed using the MATLAB program. Results: The measurements show a significant reduction in the motion of affected knees compared to the natural knees in their healthy state. After the implantation of the knee prosthesis, the motion range is increased and the values approximate those of the natural knees in their healthy state. The results show an increased degree of flexion in the PS prostheses compared to the CR ones. Moreover, the results show insignificant values of ML translation, lateral gap, and medial gap in both types of prostheses. Conclusion: The results show that there is a clear difference in gait pattern in patients with gonarthrosis, before and after the implantation of endoprosthesis. This difference can be successfully determined with OptiTrack system. Moreover, it proves that the total knee arthroplasty leads to the restored gait, however without a statistically significant difference in the range of motion after the implantation of the PS and CR knee endoprostheses.

In the field of orthopaedic surgery the main goal is to find the best treatment for the person with bone fracture or other trauma. In the treatment of the fractures of the bones, surgeons apply techniques of internal and external fixation. External fixation is a surgical technique used for stabilization of bone fragments with the fixator positioned outside of the human body (only pins and screws go inside the body). The alignment of the external fixator can be adjusted externally to provide optimal position of the bone and bone fragments during the recovery process. Internal fixation presumes use of osteofixation material (screws, pins, plate implants) inside the human body, in order to stabilize the bone fracture. Both internal and external fixation can be used for the healing of the bone fracture, but internal fixation is preferable, since there is better functional recovery of the bone. Plate implants are the most used internal fixators for the surgical treatments of the bone fractures. They are made in the various sizes and shapes, in order to be used for different patients. The application of such implants for the treatment of the unique patient bone may initiate problem because the bone and the plate implant may be different in size and shape.. In such cases it is hard to find proper position of the plate, the patient's treatment may be hampered due to inadequate transfer of load during bone healing process, etc. The problem can be reduced if the implants known as the personalized implants (PPIs) are used. The geometry and shape of PPIs are customized to the anatomy and morphology of the bone of the particular patient. Positive effects on patients are present but there is the need for more preoperative planning and production. PPIs are used in the situations when, if the predefined implant are used, it can lead to both intra-operative and post-operative complications.

Uvod: Koleno je jedinstven zglob u ljudskom telu po tome što je najveći zglob, najsloženije anatomske građe sa vrlo kompleksnom biomehanikom. Pokreti u zglobu su jako složeni i sastoje se u osnovi iz translacije i rotacije, a mogući su u sve tri ravni prostora. Određeni su kako geometrijom zglobnih površina tako i mekotkivnim omotačem zgloba. Primenom novih tehničkih dostignuća, pre svega tehnika snimanja i praćenja pokreta tela i zglobova, pruža nam se mogućnost da proučavamo biomehaniku koleno na jedan nov način. Metodologija: Cilj ove studije je da se korišćenjem OptiTrack sistema, koji se sastoji od specijalizovanih infracrvenih kamera visoke preciznosti i klasifikacionih algoritama, izmere mikro pokreti u kolenu, koji nastaju kao posledica nedostatka zadnjeg ukrštenog ligamenta. Odabrani su pacijenti koji imaju povredu zadnje ukrštene veze jednog kolena. Upoređuje se biomehanika povređenog kolena, sa zdravim zglobom suprotne strane i sa istim kolenom nakon hirurške intervencije. Rezultati: U ovoj seriji od 16 pacijenata bilo je 13 muškaraca i 3 žene, prosečne starosti 28.6 godina. Upoređujući obrasce pokreta dobijene OptiTrack sistemom kod zdravog i povređenog zgloba jasno je da je šema pokreta poremećena. Izražena je zadnja nestabilnost prikazana kroz zadnje pomeranje tibije kao i povećana spoljašnja rotacija tibije u fazi oslonca kod nestabilnog zgloba. Koristeći Vilkoksonov test, dokazano je da postoji statistički značajna razlika između zdravog i bolesnog kolena, u pogledu anteriorno-posteriorne translacije i interno-eksterne rotacije. Nakon hirurške intervencije rezultati merenja su pokazali da je biomehanika zgloba vraćena u fiziološke granice. Zaključak: Rezultati ove studije su jasno pokazali dinamičku nestabilnost koja nastaje u kolenu sa oštećenim zadnjim ukrštenim ligamentom, a koja se može objektivno izmeriti OptiTrack sistemom. Operativnim lečenjem ove povrede, pokreti kolena se vraćaju u normalne granice kao kod zdravog zgloba. Introduction: The knee is a unique joint in the human body because it is the largest joint, with the most complex anatomy and very complex biomechanics. The movements in the knee are very complicated and consist essentially of translation and rotation and are possible in all three levels of space. They are determined by the geometry of the articular surfaces and by the soft tissue of the joint. By applying new technical achievements, primarily the technique of recording and monitoring movements of the body and joints, we are able to study the biomechanics of the knee in a new way. Methodology: The aim of this study is to measure the micro-movements in the knee, which result from the lack of the posterior cruciate ligament using the OptiTrack system, which consists of specialized high precision infrared cameras and classification algorithms. Patients who have a rupture of posterior cruciate ligament of one knee were selected. The function of тhe biomechanics of an injured knee is compared with a healthy joint on the opposite side and with the same knee after surgery. Results: In this 16-patient series, there were 13 males and 3 females, with an average age of 28.6 years. Comparing patterns of motion obtained with the OptiTrack system in a healthy and injured knee, it is clear that the scheme of the movement is disturbed. The posterior instability was expressed through the posterior displacement of the tibia in the support phase of walking, as well as the increased external rotation of the tibia in the support phase in the unstable joint. Using the Wilcoxon signed-rank test, it has been shown that there is a statistically significant difference between healthy and diseased knee, in terms of anterior-posterior translation and internal-external rotation. After surgical intervention, the results of the measurement showed that the biomechanics of the joints were in normal physiological limits. Conclusion: The results of this study clearly demonstrated the dynamic instability that occurs in the knee with posterior cruciate ligament rupture that can be objectively measured by the OptiTrack system. Operative treatment of this knee injury returns movements of the joint in the normal limits as in a healthy one.

REZIME: Proizvodnja delova na numerički upravljanim mašinama alatkama jedna je od najzastupljenijih tehnika korišćenih u savremenim proizvodnim procesima. Čak i kod preciznog hladnog i toplog oblikovanja delova ili livenja delova, mnogi od završnih postupaka obrade i delova se obavljaju rezanjem na mašinama alatkama, a takođe se i alati za ove mašine, ovim tehnologijama obrađuju. CAD/CAM sistemi mogu da generišu NC programe na osnovu geometrije dela, ali ne pomažu programerima u izboru odgovarajućih strategija rezanja, geometrije alata i drugih parametara procesa. Komercijalni CAM softveri generišu CNC programe uglavnom sa matematičke tačke gledišta i obično sadrže konstantne parametre rezanja za određenu putanju alata i ne simuliraju očekivani kvalitet i tačnost obrađenih površina, a takođe ne uzimaju u obzir mehaničke aspekte procesa glodanja kao što su sile rezanja i devijacija reznog alata. Savremena merna oprema je sve prisutnija u mašinskoj industriji, pa se može reći da su koordinatne merne mašine postale standard i da se proizvodnja i dokumentacija velikim delom prilagođava koordinatnim mernim mašinama. Sa druge strane se još intenzivnije razvijaju beskontaktni (optički i laserski) merni sistemi. Ovi merni sistemi podrazumevaju kao razultat merenja oblak tačaka, koji zahteva procesiranje i generisanje površina u cilju merenja i kontrole. U okviru disertacije dat je pregled savremene merne opreme i predstavljeni su postupci generisanja površina i merenja odstupanja pomoću softvera, kao što su CATIA, GOM Inspect, PC DMIS i sl. Eksperimentalna istraživanja obuhvataju veoma veliki broj eksperimenata. U okviru prvog eksperimenta analiziran je uticaj širine rezanja na tačnost obrađenog dela. Sledećim eksperimentom obuhvaćen je uticaj brzine rezanja i pomoćnog kretanja na hrapavost obrađenog dela kao i na dimenzionalna i geometrijska odstupanja: ravnost, upravnost i paralelnost. Narednim eksperimentima istraživan je uticaj greške postavljanja (paralelne pomerenosti ose i nagnutosti ose) glodala kao i radijalnog odstupanja zuba glodala, na topografiju površine. Poslednjim eksperimentalnim ispitivanjima određivan je uticaj promene dubine rezanja, odnosno putanje glodala na dobijene dužinske i geometrijske mere. Realizovana eksperimentalna istraživanja su pokazala korelativnu zavisnost između parametara obrade i dobijenih parametara kvaliteta obrađenog dela. Odstupanja obrađenih delova identifikovana su i merena pomoću koordinatne merne mašine i različitih optičkih mernih sistema (ATOS) uz primenu odgovarajućih softvera za merenje. Takođe su izvršena poređenja dobijenih rezultata sa različitih mernih uređaja. Razvijen je algoritam za regenerisanje postojećeg NC koda u cilju korekcije odstupanja obrađenog dela koje se javljaju usled grešaka obrade. Algoritam predviđa postojanje baze podataka koje se potrepljuju eksperimentalnim istraživanjima, podacima iz obradnih procesa, rezultatima modeliranja i simulacija zavisnosti parametara obrade od tačnosti obrade. Regenerisanjem NC koda vrše se korekcije grešaka obrade, odnosno predupređuju se uzroci nastanka grešaka obrade. ABSTRACT: The production of parts using numerically controlled machine tools is one of the most used techniques in modern production processes. Even at the precise cold and hot shaping of parts or casting of parts, most of fine machining and parts are performed with cutting on machine tools, and the tools for these machines are also processed with these technologies. CAD/CAM systems can generate NC programs based on the geometry of a part, but do not help programmers in the selection of the proper cutting strategies, tool geometry and other processing parameters. Commercial CAM software develop CNC programs mostly from the mathematical point of view and commonly contain constant cutting parameters for a specific tool path and they do not simulate the expected quality and accuracy of the machined surfaces, and they also do not take into consideration the mechanical aspects of milling process such as cutting forces and cutting tool deviation. Modern measurement equipment is more present in manufacturing industries, so it can be said that the measuring machine coordinates have became the standard and that the manufacturing and documentation are adjusting to the coordinate measuring machines in a great deal. On the other hand, the non-contact (optical and laser) measuring systems are more intensively developed. These measuring systems as a result include a point cloud, which requires the processing and generating of surfaces for the purpose of measuring and control. In the framework of the dissertation is given the review of modern measuring equipment and the surface generating procedures and deviation measurements using the software, such as CATIA, Gom Inspect, PC DMIS, etc, are presented. Experimental researches include a very large number of experiments. Within the firs experiment, the impact of cutting width on the accuracy of processed part was analyzed. The following experiment included the impact of cutting speed and auxiliary movement of the roughness of the processed part as well as on the dimensional and geometrical deviations: flatness, perpendicularity and parallelism. Subsequent experiments examined the impact of error setup (parallel offset of axis and inclination of the axis) of the milling cutter as well as the radial deviation of mill tooth on the surface topography. In the final experiments the impact of the change of cutting depth, i.e., milling cutter path, on the obtained longitudinal and geometrical measures is determined. Conducted experimental researches have shown the correlative dependence between the cutting parameters and obtained quality parameters of machined part. Deviations of machined parts are identified and measured using the coordinate measuring machine and different optical measuring systems (ATOS) with the application of corresponding measuring software. The comparisons of the results obtained from the different measuring devices are also performed. An algorithm for generation of the existing NC code for the correction of the machined part deviations that occur due to machining error is developed. The algorithm predicts the existence of database that is supported by experimental research, data from machining processes, results of modeling and simulation of machining parameters dependence on the accuracy of the processing. Regeneration of NC code By regenerating the NC code the correction of processing errors is made, i.e., the causes of processing errors are prevented.

Customized implants are complex free geometrical forms. Requests for its precision, appropriate material selection and manufacturing time require that even at the designing phase right decisions are made. That is why customized implant manufacturability analysis and the use of artificial intelligence are very important. Customized implant knowledge model will be created and system for acquisition, systematization, and modeling of knowledge about customized implant designing and manufacturing will be developed. By creating knowledge basis we make a foundation for creating adaptable expert system for customized implant manufacturability analysis. It will be a part of a system for designing, manufacturing and monitoring workflow, based on web technologies.

Gait is a fundamental human activity. One of the main joints that participate in walking process is knee joint. This joint is considered to be the largest and most complex joint in human body. This complexity comes from possibility of translation and rotation along and around all axes. All of these movements have corresponding pattern. Main purpose of this doctoral thesis is to identify and analyze standard values and patterns of basic movement parameters of healthy individuals. Experimental research was done in Clinical Centre Kragujevac on healthy individuals and on patients with deficient/diseased soft tissue and/or cartilaginous knee structures. Three systems were used for acquiring data – OptiTrack, Kinetic XBOX camera and simple web camera. Mathematical model of a knee was created for calculating identified gait parameters. It is concluded, with a help of statistical methods, that there is a significant difference in gait pattern between healthy individuals and patients with deficient/diseased knee joint structures. For the purpose of getting objective results, models for predicting/classification (based on logistic regression and neural network models) possible damage/illness of knee joint based on walk parameters values and gait curves were created. Models for predicting/classification are valued by diagnostic tests. Results showed that this approach can help in better understanding of processes in knee joint that occur during walking, can help to achieve objectivity in walking process evaluation, improve rehabilitation process depending on level of recovery of the patient, etc.

UVOD: Podaci iz literature pokazuju da je ruptura prednje ukrštene veze kolena, početak kraja kolena“ tj. da povrede ovog ligamenta vode ka razvoju hronične nestabilnosti kolena i bržem razvoju degenerativnih promena. Cilj hirurške rekonstrukcije je postizanje bolje stabilnosti zgloba kolena. Dosadašnji testovi koji se koriste za postavljanje dijagnoze nestabilnosti kolena kod pacijenata sa povredom prednje ukrštene veze su pre svega subjektivni dijagnostički testovi. Zbog toga je osnovni cilj ove studije da se definiše objektivni test za postavljanje dijagnoze nestabilnosti kolena zasnovan na realnim merenjima pomoću kamera i softverskih programa i na taj način se smanjuje mogućnost greške pri postavljanju indikacija za hirurško lečenje, kao i izbor hirurške intervencije. Test može da se koristi i kao pokazatelj uspešnosti hirurške intervencije, odnosno u kom procentu se uspostavlja stabilnost kolena i normalizacija hoda. METOD: U studiju su biti uključeni svi pacijenti sa povredom prednje ukrštene veze (sportske i druge povrede) kod kojih je postavljena indikacija za hirurško lečenje na osnovu kliničog pregleda. Svi pacijentima je urađena artroskopski asistirana rekonstrukcija prednje ukštene veze, sa autogrefonom tetiva hamstringsa iste noge. Ispitivanje hoda će se vršiti uz pomoć trodimenzionalnog OptiTrack sistema na dan pre operacije, 7.dana, 14. dana i 6 nedenja posle operacije. REZULTATI: Rezultati dobijeni u ovom istraživanju omogućavaju precizniju dijagnozu ligamentarne nestabilnosti kolena. Trodimenzionalni OptiTrack sistem je objektivni pokazatelj nestabilnosti kolena nakon povrede prednje ukrštene veze u odnosu na dosadašnje testove. Potvrdili smo da postoji statistički značajna razlika u kinematici zgloba kolena zdrave noge i noge sa povredom prednjeg ukrštenog ligamenta. Posle hirurške rekonstrukcije prednje ukrštene veze, kinematika zgloba operisanog kolena se približava kinematici zdravog zgloba kolena. Pokazali smo da ugao tibiofemoralne rotacije povređenog kolena pokazuje maksimalnu rotaciju u početnoj fazi hoda. Abstract: INTRODUCTION: Data from the literature show that the rupture of the anterior cruciate ligament, "END of the knee ", ie. that violations of this ligament lead to development of chronic knee instability and faster development of degenerative changes. The goal of surgical reconstruction is to achieve better stability of the knee joint. The previous tests used to diagnose knee instability in patients with injury anterior cruciate ligament are primarily subjective diagnostic tests. Therefore, the basic aim of this study is to define an objective test for the diagnosis of knee instability based on actual measurements using cameras and software programs, thus reducing the possibility of mistakes in setting the indications for surgical treatment, as well as the choice of surgical intervention. The test can also be used as an indicator of the success of surgical intervention, and what percentage is established knee stability and normalization walk. METHODS: The study included all patients be with injury anterior cruciate ligament (sporting and other injuries) in which the indication for surgical treatment based on clinical examination. All the patients underwent arthroscopic assisted reconstruction of the anterior cruciate ligamentn with hamstring graft of the same leg. Gait analisys were performed with the help of three-dimensional OptiTrack system on the day before surgery, 7th day, 14th day and 6 weeks after surgery. RESULTS: The results obtained in this study allow more precise diagnosis of knee ligament instability. Three-dimensional OptiTrack system is an objective indicator of instability of the knee after ACL injuries compared to previous tests. We have confirmed that there is a statistically significant difference in the kinematics of the knee joint healthy feet and legs with the injury of the anterior cruciate ligament. After surgical reconstruction of the anterior cruciate ligament, the operated knee joint kinematics is approaching a healthy knee joint kinematics. We have shown that the angle of tibiofemoral rotation injured knee shows the maximum rotation in the initial phase of walking.

U ovom doktorskom radu, koji je rezultat integralnih i interdisciplinarnih istraživanja u oblasti biomedicine, opisan je razvoj ontologije skolioze kičme OBR-Scolio i ontološki baziranog informacionog sistema ScolioMedIS, za dijagnostikovanje i monitoring deformiteta kičmenog stuba. Informacioni sistem ScolioMedIS omogućava evidentiranje vizuelnog pregleda pacijenta sa skoliozom, korišćenjem elektronskog kartona skolioze, koji se bazira na inovativnom protokolu. Osim toga, informacioni sistem ScolioMedIS omogućava vizuelni 2D i 3D prikaz: spoljašnje linije simetrije leđa, unutrašnje kičmene linije i oblaka tačaka leđa pacijenta, kao i automatsko određivanje Kobovih uglova kičmenih krivina pacijenata u frontalnoj i bočnoj ravni u uspravnom položaju, korišćenjem postupka optičkog skeniranja. Osim toga, informacioni sistem ScolioMedIS omogućava vizuelni 2D prikaz spoljašnje linije simetrije leđa i unutrašnje kičmene linije i određivanja Kobovih uglova u frontalnoj ravni u položajima prilikom savijanja pacijenta u levu i desnu u stranu, korišćenjem digitalne kamere. Nadalje informacioni sistem omogućava i vizuelni 3D prikaz kičme pacijenta, modifikacijom opšteg 3D CAD modela kičme, na osnovu automatski dobijenih parametara iz informacionog sistema ScolioMedIS, korišćenjem postupka optičkog skeniranja. Osim navedenog, korišćenjem ontologije skolioze kičme informacioni sistem obezbeđuje automatsko određivanje tipa skolioze prema Lenkovoj klasifikaciji i ispis statističkih podataka zastupljenosti pojedinih Lenkovih tipova skolioze i njihovih karakteristika u kratkoročnom ili dugoročnom vremenskom periodu, radi analize i međusobnog poređenja. S obzirom da se u procesu dijagnostike i monitoringa skolioze ScolioMedIS informacioni sistem potpuno bazira na korišćenju optičkih, ne-jonizujućih metoda, osnovna prednost korišćenja ovog sistema za monitoring i dijagnostiku skolioze u odnosu na konvencionalni način monitoringa i dijagnostike korišćenjem radiografije je eliminacija štetnog rendgenskog zračenja. Informacionom sistem ScolioMedIS je namenjen potrebama Centra za fizikalnu medicinu i rehabilitaciju Kliničkog centra u Kragujevcu, ali se takođe može koristiti i za regionalno praćenje i dijagnostikovanje deformiteta kičmenog stuba i u drugim zdravstvenim centrima u zemlji i inostranstvu. This doctoral thesis is a result of integrated and interdisciplinary researches in biomedical field and it describes the development of scoliosis ontology OBR-Scolio and ontology-based information system ScolioMedIS for diagnosing and monitoring of spine deformities. ScolioMedIS enables recording visual examination of the patient with scoliosis using electronic scoliosis forms based on an innovative protocol. In addition, information system ScolioMedIS enables 2D and 3D visualizations of point’s cloud of back; back symmetry line and inner spinal line, as well as automatic determination of Cobb angles in the frontal and sagittal planes in upright standing patient’s position by employing optical scanning method. Furthermore, the information system provides 2D visualizations of back symmetry line, inner spinal line, as well as automatic determination of Cobb angles in the frontal plane, in side bending patient’s position, using digital camera method. Information system ScolioMedIS enables 3D visualization of the patient’s spine by modifying the generic 3D CAD model of the spine according to parameters which are automatically generated by the ScolioMedIS system using optical scanning method. In addition to this, the information system provides automatic determination of Lenke’s type of scoliosis, statistical overviews in short-term or long-term period for analysis and mutual comparison by employing the scoliosis ontology. Considering that in the process of diagnosing and monitoring of scoliosis, ScolioMedIS information system is fully based on optical and non-ionizing methods, the basic advantage of the system usage for monitoring and diagnosis of scoliosis, compared to the conventional radiography based way of scoliosis monitoring and diagnosing is elimination of harmful X-rays. Although information system ScolioMedIS is dedicated for needs of Center for Physical Medicine and Rehabilitation in “Clinical Center Kragujevac”, it could be also used for regional monitoring and diagnosing scoliosis in other health centers in the country and abroad

Ovaj rad ima za cilj da prouči fenomen digitalne rekonstrukcije i prepoznavanja spoljašnjih anatomskih pokazatelja i uparivanja istih sa raznim vidovima deformiteta kičmenog stuba u cilju neinvazivne identifikacije deformiteta. Pristup je zasnovan na korišćenju digitalizovanih dorzalnih površi pacijenata, dobijenih različitim modalitetima i senzorima. Analizom 3D krivina i njenih projekcija u sagitalnoj i frontalnoj ravni detektuje se stepen deformiteta, kao i progresija, čime se stvaraju osnove za neinvazivnu dijagnostiku i praćenje, trenda stanja pacijenta tokom sprovođenja terapije. Istraživanje je usmereno ka sveobuhvatnoj proceni trenda i zastupljenosti idiopatskih skolioza i drugih deformiteta, kroz razvoj novih 3D sistema za vizuelizaciju i dijagnostiku deformiteta. Očekuje se da ovakav pristup značajno unapredi postojeće metode u radu sa pacijentima, kao i da stvori čvrstu osnovu za kreiranje Web-orijentisanih baza podataka, informacionih sistema i relevantnih aplikacija za praćenje deformiteta kičmenog stuba. Tradicionalna dijagnostika deformiteta kičmenog stuba, koja podrazumeva izlaganje pacijenata štetnom jonizujućem zračenju, zamenjuje se novim neinvazivnim (bezopasnim) metodama. Kako bi se izbegle ili značajno redukovale metode koje su potencijalno opasne, primenjuju se i razvijaju nove na bazi optičkih i laserskih uređaja za snimanje topografije leđne površi. Rezultat takvog snimanja je oblak tačaka, odnosno diskretizovana reprezentacija složene, deformabilne dorzalne površi. 3D rekonstrukcija i semantička identifikacija/anotacija skulpturnih i „free form” površi predstavlja veliki izazov u nauci. To se posebno odnosi na pristupe njihovoj registraciji (prepoznavanju diskretizovanih zapisa dobijenih različitim multi-senzorskim mernim sistemima za različite konfiguracije), matematičkom opisu, prostornoj i ravanskoj analizi, parametarske opise deformabilnosti površi, identifikaciju i opis ostalih parametara kojima se bliže definiše deformitet i topologija (tip krivina, spoljašnji i unutrašnji pokazatelji, aksijalna rotacija, i sl.). Jedan od osnovnih ciljeva rada na doktorskoj disertaciji je razvoj novih algoritama za 3D registraciju, modeliranje i sveobuhvatnu analizu diskretizovanih deformabilnih skulpturnih dorzalnih površi pacijenata sa deformitetima kičmenog stuba. Primena tih algoritama putem Internet portala treba da doprinese bržem i preciznijem dijagnostikovanju deformiteta kičmenog stuba, pouzdanoj klasifikaciji, permanentnom monitoringu, kao i kreiranju Web-orijentisanih baza podataka za regionalno praćenje rasprostranjenosti, opštih i specifičnih karakteristika oboljenja. U tom smislu, planirana je verifikacija rezultata kroz kliničku implementaciju i testiranje Web-orijentisanog sistema za praćenje deformiteta kičmenog stuba (skolioza, kifoza, lordoza) pozantijeg pod nazivom ScolioMedIS u Centru za fizikalnu medicinu i rehabilitaciju i Klinici za ortopediju i traumatologiju Kliničkog centara Kragujevac, ali i u drugim zainteresovanim zdravstvenim ustanovama u regionu. This dissertation aims in studying the phenomenon of digital (virtual) recognition of external anatomical parameters (indices) and matching them with various modalities of spinal deformities in order to provide noninvasive identification and classification of the deformities. The approach is based on the usage of digitized patients’ back surface obtained by various modalities and sensors. Analysis of 3D curves and their projections in the sagittal and frontal planes the degree of deformity can be detected, as well as the deformity progression, thus creating the basis for noninvasive diagnosis and monitoring of the disease, its trend and dynamics during the therapy. This research is directed towards a comprehensive assessment of the trend and the presence of idiopathic scoliosis and other deformities, through the development of new 3D classification scheme for the deformity ranking. It is expected that this approach will significantly improve the existing methods of patient’s treatment, and to create a sound basis for creation of Web-oriented databases, information systems and relevant applications for spinal deformity monitoring. Traditional diagnosis methods of spinal deformities, which involve exposing the patients to harmful ionizing radiation, are replacing by a new non-invasive (harmless) methods. In order to avoid or significantly reduce the methods that are potentially dangerous and harmful, new ones are developing based on optical and laser devices for imaging of the surface topography of the back. The result of such scanning is a cloud of points, i.e. discretized representation of the complex, deformable (non-rigid, elastic) surfaces of the human back. 3D reconstruction and semantic identification/annotation of sculptured and “free form” surfaces emerge as a big scientific challenge. This especially holds for the approaches to their registration (recognition of discretized records obtained by various multi-sensor measurement systems at different configurations), spatial and planar analysis, parametric descriptions of the elastic deformation of the surfaces, and identification and description of other parameters that more closely define the deformity and its topology (type of curvature, translation, rotation, etc.). One of the main goals of the Ph.D. thesis is the development of new algorithms for the registration and comprehensive analysis of the discretized deformable sculptured surface of a back and a chest of patients with spinal deformities. The application of these algorithms through the Internet portal should contribute to faster and more accurate diagnosis of spinal deformities, reliable classification, permanency of monitoring, as well as creating Web-oriented databases for regional monitoring of presence, general and specific disease characteristics. In that course, it is planned to verify the research results through the clinical implementation and validation of Web-oriented system for spinal deformities (scoliosis, kyphosis, lordosis) monitoring at the Center for Physical Medicine and Rehabilitation and the Clinic of Orthopedics and Traumatology, both units of Clinical Center Kragujevac (Serbia), as well as in other interested health care institutions in the region.