临床应用下颈椎韧带几何个性化有限元模型的开发和验证。

PubMed ID
G H
发表日期 2019年06月

原始出处 生物和医学中的计算机
Computers in biology and medicine
作者 Nikkhoo  Mohammad  Cheng  Chih-Hsiu  Wang  Jaw-Lin  Khoz  Zahra  El-Rich  Marwan  Hebela  Nader  Khalaf  Kinda 

文献标题 临床应用下颈椎韧带几何个性化有限元模型的开发和验证。
Development and validation of a geometrically personalized finite element model of the lower ligamentous cervical spine for clinical applications.
Development and validation of a geometrically personalized finite element model of the lower ligamentous cervical spine for clinical applications.

文献摘要

流行病学和临床研究表明,随着世界人口老龄化的加剧,宫颈疾病的规模和范围都在上升。从生物力学角度来看,颈椎表现出广泛的个体间变异性,其运动模式和负荷分担强烈依赖于解剖结构。这项研究的目的是首先开发和验证一个用于临床应用的下颈椎几何模型,然后使用该模型研究与典型颈椎疾病相关的脊柱生物力学。通过对X线片30个参数的测量,建立了颈椎和椎间盘的三维几何模型,并建立了6名受试者下颈椎韧带的有限元模型。然后将这些模型用于研究不同程度的IVD改变。多向运动范围(ROM)的结果与体外和电子研究一致,证实了模型的有效性。椎间盘C5和C6-ROM水平有明显的改变(C6-ROM)和邻近椎间盘的轴向旋转和压力轻微降低。3级改变和相邻节段的纤维环(AF)和小关节面关节力的最大应力增加。本研究中提出的新颖的几何个性化有限元分析方法可能为临床界提供一个有价值的定量工具,用于非侵入性分析颈椎病相关的生物力学改变,从而改进手术计划和提高临床疗效。


Epidemiological and clinical studies show that the magnitude and scope of cervical disease are on the rise, along with the world's rising aging population. From a biomechanical perspective, the cervical spine presents a wide inter-individual variability, where its motion patterns and load sharing strongly depend on the anatomy. This study aimed to first develop and validate a geometrically patient-specific model of the lower cervical spine for clinical applications, and secondly to use the model to investigate the spinal biomechanics associated with typical cervical disorders. Based on measurements of 30 parameters from X-ray radiographs, the 3D geometry of the vertebrae and intervertebral discs (IVDs) were developed, and detailed finite element models (FEMs) of the lower ligamentous cervical spine for 6 subjects were constructed and simulated. The models were then used for the investigation of different grades of IVD alteration. The multi directional range of motion (ROM) results were in alignment with the in-vitro and in-Silico studies confirming the validity of the model. Severe disc alteration (Grade 3) presented a significant decrease in the ROM and intradiscal pressure (flexion, extension, and axial rotation) on the C5-C6 and slightly increase on the adjacent levels. Maximum stress in Annulus Fibrosus (AF) and facet joint forces increased for Grade 3 for both altered and adjacent levels. The novel validated geometrically-personalized FEM presented in this study potentially offers the clinical community a valuable quantitative tool for the noninvasive analyses of the biomechanical alterations associated with cervical spine disease towards improved surgical planning and enhanced clinical outcomes.

Epidemiological and clinical studies show that the magnitude and scope of cervical disease are on the rise, along with the world's rising aging population. From a biomechanical perspective, the cervical spine presents a wide inter-individual variability, where its motion patterns and load sharing strongly depend on the anatomy. This study aimed to first develop and validate a geometrically patient-specific model of the lower cervical spine for clinical applications, and secondly to use the model to investigate the spinal biomechanics associated with typical cervical disorders. Based on measurements of 30 parameters from X-ray radiographs, the 3D geometry of the vertebrae and intervertebral discs (IVDs) were developed, and detailed finite element models (FEMs) of the lower ligamentous cervical spine for 6 subjects were constructed and simulated. The models were then used for the investigation of different grades of IVD alteration. The multi directional range of motion (ROM) results were in alignment with the in-vitro and in-Silico studies confirming the validity of the model. Severe disc alteration (Grade 3) presented a significant decrease in the ROM and intradiscal pressure (flexion, extension, and axial rotation) on the C5-C6 and slightly increase on the adjacent levels. Maximum stress in Annulus Fibrosus (AF) and facet joint forces increased for Grade 3 for both altered and adjacent levels. The novel validated geometrically-personalized FEM presented in this study potentially offers the clinical community a valuable quantitative tool for the noninvasive analyses of the biomechanical alterations associated with cervical spine disease towards improved surgical planning and enhanced clinical outcomes.


获取全文 10.1016/j.compbiomed.2019.04.010