A comprehensive finite element model of surgical treatment for cervical myelopathy

Stoner, Kirsten E.; Abode-Iyamah, Kingsley; Fredericks, Douglas C.; Viljoen, Stephanus; Howard, Matthew A.; Grosland, Nicole M.

doi:10.1016/j.clinbiomech.2020.02.009

Cited by 23 publications

(31 citation statements)

References 48 publications

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“…At the state of maximum deformation, nearly all of the kinetic energy of the pellet was transformed into internal energy stored in the soft tissues, approximately 32%–35% of which was stored in the dura mater. This contrasts other recent FE spinal cord models, where a linear elastic modulus was used to characterize the dura mater, ranging from 2.3 to 231 MPa 7,41 . Linear elastic models do not consider the non‐linear response and orthotropic of the dura mater that will influence the prediction of overall strains and stresses in the spinal cord, leading to inaccuracies in predicting spinal cord deformation during impact.…”

Section: Discussionmentioning

confidence: 88%

“…Other studies have chosen to exclude the CSF from spinal cord FE models and acknowledged it as a limitation of the spinal cord response predicted by their model. 5 In terms of the dura mater, most of the previous FE models simplified the mechanical properties to the dura mater to linear elastic behavior, [5][6][7][8]36,37,41 while some others have used a viscoelastic representation of this tissue. 40,42 Although many individual previous studies have investigated various methods for representing the CSF and dura mater, no previous study has made a consistent quantitative comparison of the methods under the same simulation conditions, making the specific findings of the CSF and dura mater implementation from each study challenging to compare.…”

Section: Spinal Cord Materials Models and Parametersmentioning

confidence: 99%

“…The authors identified a need for further validation of the SPH methodology, including using SPH implementation for simulation of impact scenarios. Another study modeled CSF as simple PV without fluid exchange, 41 while other studies have modeled the CSF using a Lagrange mesh along with a hyperelastic constitutive model 42 . However, large compression and corresponding outflow of the CSF experienced during spinal cord impact may not be well captured by PV and Lagrange implementations.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of numerical methods for cerebrospinal fluid representation and fluid–structure interaction during transverse impact of a finite element spinal cord model

Rycman

McLachlin

Cronin

2022

Numer Methods Biomed Eng

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Spinal cord impacts can have devastating consequences. Computational models can investigate such impacts but require biofidelic numerical representations of the neural tissues and fluid–structure interaction with cerebrospinal fluid. Achieving this biofidelity is challenging, particularly for efficient implementation of the cerebrospinal fluid in full computational human body models. The goal of this study was to assess the biofidelity and computational efficiency of fluid–structure interaction methods representing the cerebrospinal fluid interacting with the spinal cord, dura, and pia mater using experimental pellet impact test data from bovine spinal cords. Building on an existing finite element model of the spinal cord and pia mater, an orthotropic hyperelastic constitutive model was proposed for the dura mater and fit to literature data. The dura mater and cerebrospinal fluid were integrated with the existing finite element model to assess four fluid–structure interaction methods under transverse impact: Lagrange, pressurized volume, smoothed particle hydrodynamics, and arbitrary Lagrangian–Eulerian. The Lagrange method resulted in an overly stiff mechanical response, whereas the pressurized volume method over‐predicted compression of the neural tissues. Both the smoothed particle hydrodynamics and arbitrary Lagrangian–Eulerian methods were able to effectively model the impact response of the pellet on the dura mater, outflow of the cerebrospinal fluid, and compression of the spinal cord; however, the arbitrary Lagrangian–Eulerian compute time was approximately five times higher than smoothed particle hydrodynamics. Crucial to implementation in human body models, the smoothed particle hydrodynamics method provided a computationally efficient and representative approach to model spinal cord fluid–structure interaction during transverse impact.

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Section: Discussionmentioning

confidence: 88%

Section: Spinal Cord Materials Models and Parametersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of numerical methods for cerebrospinal fluid representation and fluid–structure interaction during transverse impact of a finite element spinal cord model

Rycman

McLachlin

Cronin

2022

Numer Methods Biomed Eng

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“…However, there are few analyses of laminoplasty models in the literature. Stoner compared intact, laminectomy, and double-door laminoplasty models for spinal cord [38]. Tejapongvorachai reported that the stabilities of the hinge sides of plate-augmented open-door laminoplasties based on cutting in a curved or straight line were compared using a FE model and the potential of the proposed technique to reduce the risk of hinge fracture and displacement [39].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of Posterior Ligaments of Cervical Spine and Laminoplasty

et al. 2021

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Cervical laminoplasty is a valuable procedure for myelopathy but it is associated with complications such as increased kyphosis. The effect of ligament damage during cervical laminoplasty on biomechanics is not well understood. We developed the C2–C7 cervical spine finite element model and simulated C3–C6 double-door laminoplasty. Three models were created (a) intact, (b) laminoplasty-pre (model assuming that the ligamentum flavum (LF) between C3–C6 was preserved during surgery), and (c) laminoplasty-res (model assuming that the LF between C3–C6 was resected during surgery). The models were subjected to physiological loading, and the range of motion (ROM), intervertebral nucleus stress, and facet contact forces were analyzed under flexion/extension, lateral bending, and axial rotation. The maximum change in ROM was observed under flexion motion. Under flexion, ROM in the laminoplasty-pre model increased by 100.2%, 111.8%, and 98.6% compared to the intact model at C3–C4, C4–C5, and C5–C6, respectively. The ROM in laminoplasty-res further increased by 105.2%, 116.8%, and 101.8% compared to the intact model at C3–C4, C4–C5, and C5–C6, respectively. The maximum stress in the annulus/nucleus was observed under left bending at the C4–C5 segment where an increase of 139.5% and 229.6% compared to the intact model was observed for laminoplasty-pre and laminoplasty-res model, respectively. The highest facet contact forces were observed at C4–C5 under axial rotation, where an increase of 500.7% and 500.7% was observed compared to the intact model for laminoplasty-pre and laminoplasty-res, respectively. The posterior ligaments of the cervical spine play a vital role in restoring/stabilizing the cervical spine. When laminoplasty is performed, the surgeon needs to be careful not to injure the posterior soft tissue, including ligaments such as LF.

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“…Another important contribution of FEM is the biomechanically validated prediction for both healthy and myelopathic spinal cord displacement when compared to in vivo motions [49,52]. Spinal cord strain was raised during extension in the cervical myelopathy FEM.…”

Section: Degenerative Disc Diseasementioning

confidence: 99%

Finite Element Method for the Evaluation of the Human Spine: A Literature Overview

Naoum

Vasiliadis

Koutserimpas

et al. 2021

JFB

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The finite element method (FEM) represents a computer simulation method, originally used in civil engineering, which dates back to the early 1940s. Applications of FEM have also been used in numerous medical areas and in orthopedic surgery. Computing technology has improved over the years and as a result, more complex problems, such as those involving the spine, can be analyzed. The spine is a complex anatomical structure that maintains the erect posture and supports considerable loads. Applications of FEM in the spine have contributed to the understanding of bone biomechanics, both in healthy and abnormal conditions, such as scoliosis, fractures (trauma), degenerative disc disease and osteoporosis. However, since FEM is only a digital simulation of the real condition, it will never exactly simulate in vivo results. In particular, when it concerns biomechanics, there are many features that are difficult to represent in a FEM. More FEM studies and spine research are required in order to examine interpersonal spine stiffness, young spine biomechanics and model accuracy. In the future, patient-specific models will be used for better patient evaluations as well as for better pre- and inter-operative planning.

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A comprehensive finite element model of surgical treatment for cervical myelopathy

Cited by 23 publications

References 48 publications

Comparison of numerical methods for cerebrospinal fluid representation and fluid–structure interaction during transverse impact of a finite element spinal cord model

Comparison of numerical methods for cerebrospinal fluid representation and fluid–structure interaction during transverse impact of a finite element spinal cord model

Biomechanical Analysis of Posterior Ligaments of Cervical Spine and Laminoplasty

Finite Element Method for the Evaluation of the Human Spine: A Literature Overview

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