Momentum Health, Formerly Known as SeeSpine, Is Using New Camera Tech to Help Scoliosis Patients…

Momentum Health, Formerly Known as SeeSpine, Is Using New Camera Tech to Help Scoliosis Patients Avoid Harmful X-rays

The team of Canadian and Dutch founders leveraged technology called photogrammetry in order to make scoliosis monitoring fast and safe for millions of patients.

Challenge

Often in business, the goal is to keep ahead of the curve. When it comes to the new telehealth company Momentum Health (formerly SeeSpine), that goal is literal. Adolescent Idiopathic Scoliosis (AIS), that curve of the spine your gym teacher might have checked for in elementary school, is the most prevalent spine deformity, affecting 1–3% of children (a million annually) in North America. And when it comes to treatment, every degree you can prevent the spine from curving helps.

The problem is that scoliosis can be hard to diagnose. Children aren’t regularly screened for the condition and their growth fluctuates wildly during childhood and early adolescence, meaning a curve that seems stable might dramatically change in a short amount of time. Catching a curve early is imperative: 75% of spinal curvature can be slowed or stopped through the use of a brace. While surgery is an option, it is incredibly invasive.

Even if a case of AIS is identified, monitoring its progression brings a whole other raft of challenges. The standard of care for tracking progression is four X-rays a year. Not only does this expose young patients to the harmful effects of radiation with some devastating results–for example, women with scoliosis are twice as likely to develop breast cancer later in life–but it also comes with a high rate of human error for reading these results. When a provider who isn’t skilled at treating scoliosis reads the X-ray (including pediatricians and chiropractors) there is an estimated 25% error rate.

This puts patients in a bit of a Catch-22 when it comes to their condition: their only option to effectively track and stabilize their curvature to prevent an invasive surgery involves risking their health through repeated X-rays — X-rays that might then be misread. The pervasive mood on chat boards devoted to scoliosis can be a sense of powerlessness; patients wish they could know what was happening to their spines while they wait six months for their next X-ray or wish they could just DO something, anything, to have more ownership over what is happening to them.

Origin Story

Evan Dimentberg had some time on his hands. It was the first summer of the pandemic and there were limited work options for a medical masters student as hospitals limited non-essential staff and personnel. Dimentberg used this unexpectedly free summer to research, burying himself in scientific journals and studies. One particular article, detailing the problem of radiation and scoliosis monitoring for adolescents intrigued him. Back in high school, Dimentberg spent two weeks observing Jean Ouellet, MD, the President of the Canadian Pediatric Spine Society and a surgeon at Montreal Children’s Hospital, and he wondered what Dr. Ouellet might think of this problem. Dimentberg wrote it down and tucked the article away.

Fast forward a few months and Dimentberg needed to present his idea for a medical research project for his masters degree. He pitched his idea for coming up with a non-radiation monitoring system for scoliosis to Dr. Ouellet and got the green light to explore possible solutions as his research focus. But where to begin? What might possibly work?

After some false starts (and some non-starters), Dimentberg heard about the idea of photogrammetry. It is used to make 3-D renderings and often used by engineers in construction to identify and predict problems with buildings or bridges.

What if, Dimentberg wondered, you treated the human body like the structure of a building and used photogrammetry to identify structural issues, like the degree of a spinal curvature? It held promise, but he had a lot of questions. To answer them, he hopped on Upwork, the freelancer-for-hire site, searched “photogrammetry,” picked the first guy that came up, someone in South Africa, and paid him $50 for an hour of simply answering questions.

Not only did this conversation help corroborate Dimentberg’s hunch that he was on the right track with the methodology, this freelancer in South Africa also made a connection between Dimentberg and two photogrammetry specialists in the Netherlands, Frank de Wijk and Leander Goor. He sent them an email and now two years later, they are on board with Momentum Health as co-CTOs and co-founders.

“That hour through Upwork was the best $50 I’ve ever spent,” says Dimentberg with a laugh.

Over the course of 2021, Dimentberg and Dr. Ouellet conducted research and development on their concept, running a clinical trial that proved out their hunch that photogammetry and AI algorithms could predict spinal curvature–the outside topography of a body revealing issues in the internal structure. Instead of expensive and potentially harmful X-rays, they were developing a feasible way for patients to monitor themselves from home using the camera on their phone. What they found answered the two main challenges of tracking scoliosis: radiation exposure and discontinuous follow-up riddled with human error.

Under the Hood

Momentum Health is a mobile application that allows you to remotely recreate the 3D surface topography of a body using a smartphone camera. This scan is used to assess and predict spinal curve progression and guide clinical decisions for the treatment of scoliosis. It takes 15 seconds, can be done as often as the patient wants, and tracks spinal curvature progression with greater precision.

“Our goal is to allow patients to take control of their care, manage and track their progression, and feel a little bit more in control of their disease,” explains Phillippe Miller, Momentum Health’s CEO and Co-founder. Miller’s been engaging with scoliosis support groups and patients to get a read on what they are looking for when it comes to their condition.

“Patients feel lost in their care. They see a doctor and are told to come back six months later and they have no idea what’s happening in the meantime. They want to feel like they’re doing something, like they have more ownership over their bodies.”

Momentum Health also aims to empower primary care physicians who don’t have the experience or tools to follow up with their scoliosis patients. Orthopedic surgeons should only see that 5% or so of patients who require bracing or surgery. Ideally, 95% of patients should be able to stay with their family doctor, but because measuring scoliosis is a complex process, patients end up in flux, with their family doctor passing them off to the ortho, only for the ortho to send them right back since surgery or bracing isn’t required.

Momentum Health addresses these issues of accuracy and consistency in treatment in a few ways. First, because the AI is automated it helps take out the issue of human error in reading a scan. There are controls built into the software that point out if an image wasn’t made correctly, for example, if the lighting is off or the wrong body part is captured. Second, because the measurements are made more frequently, it helps correct for mistakes: the repetition weeds out aberrations. And because the method is radiation free, there’s no harm redoing a scan as often as needed to get it right.

Currently, the team is building out their mobile app for patients with an existing scoliosis diagnosis to use at home or at their point of care. The scan uploads to a physician web portal to track progression of their curvature. It’s a B2B2C approach where they market the product to physicians who then invite patients to use the app for at-home tracking. In the future, they plan to add a direct to consumer diagnosis platform that allows families to screen for scoliosis at home.

As they talk with consumers and physicians, they are gaining a lot of traction in remote communities who don’t have access to regular monitoring. As Dimentberg explains, “Even in Quebec where we are based, we hear about patients who have a five-to-six-hour drive just to get a consult with a pediatric spine surgeon. They drive all that way to get an X-ray that they don’t actually need.”

They are launching further trials to help build out a comprehensive data set and provide proof of concept. This data will be important to help Momentum Health overcome some of the skepticism in the scoliosis community. “People have been trying to tackle this issue of monitoring without radiation for so long and the attempts haven’t hit the mark. We are going to show that we are different,” says Miller.

Why We’re Proud to Invest

StartUp Health is confident in backing Momentum Health’s mission to detect and track spine curve progression in a safer, more effective way, because of their founding team’s combination of deep technical background with medical know-how. They’ve assembled a global team that combines the best of photogrammetry in their dual CTOs de Wijk and Goor, with acclaimed pediatric spine surgeon Dr. Jean Ouellet’s expertise in the field directing their clinical steps.

It’s also a team that balances each other’s personalities and proclivities well. The two young co-founders, Dimentberg and Miller, bring a healthy amount of ambition and drive to the workflow, which helps in a field like medicine where advancements in methodology tend to move at a more glacial pace. Dr. Ouellet’s steadying hand makes sure they are checking the boxes when it comes to confirming and demonstrating the effectiveness of the app, and Wiljk and Goor stand in the middle, using their deep domain expertise to help the team move forward on important decisions.

We’re also proud to invest because of their innovative approach that brings the best of 3D topography to the healthcare world. It’s an unusual approach with far-reaching implications. It also shows Momentum Health is willing to look at old problems in new ways and aren’t afraid to take calculated risks. Their initial findings indicate that this risk stands to return substantial rewards for scoliosis patients and their care providers and puts them ahead of the curve in revolutionizing spinal monitoring.

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Momentum Health, Formerly Known as SeeSpine, Is Using New Camera Tech to Help Scoliosis Patients… was originally published in StartUp Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

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