To get spinal curve, the most common approach is to drop points at the tip of the spinous process of each vertebra (in CT) or along the spinal canal (in CT or MRI) and connect them with a spline.
You only need centerline extraction if you segment something. VMTK is quite robust, so it can extract centerline of anything that vaguely resembles a tube shape. In the spine, the spinal canal is a good choice. You could segment the vertebral bodies, too but then you would probably want to solidify (if you want to extract a single curve and not a network).
All these are already implemented in 3D Slicer:
Without segmentation:
With segmentation:
Once you have centerline curve, you can use Curved Planar Reformat module (provided by Sandbox extension) to straighten the curve and/or compute mapping between the spine curve and a straight line.
This allows you to make measurements, as shown here:
Or you can straighten the entire skeleton as shown here:
Andras
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