A graphical guide for constructing a finite element model of the cervical spine with digital orthopedic software

Wu, Weidong; Han, Zhihua; Hu, Bin; Du, Chun; Xing, Zehua; Zhang, Chao; Gao, Jun; Shan, Bin; Chen, Chun

doi:10.21037/atm-20-2451

Cited by 17 publications

(9 citation statements)

References 42 publications

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“…Finite element analysis can deal with these limitations and obtain satisfactory results as well as detailed internal information of the cervical spine; furthermore, it can possibly provide interpretations for postoperative symptoms ( Yuchi et al, 2019 ). As a digital research tool, finite element analysis can assess cervical spine kinematics or biomechanics, can simulate various clinical situations, and has been widely applied to spine biomechanical research so far ( Wu W. et al, 2021 ; Sang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3–C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.

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Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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“…Computational and Mathematical Methods in Medicine so the distribution of the spatial structure of the model is consistent with the real object. At present, a large number of studies have used the Mimics software to build cervical VB for finite element analysis and clinical surgical procedures [27][28][29]. In this study, the screw placement area was refined and divided into 9 zones, and the screw placement parameters of each zone were analyzed.…”

Section: Discussionmentioning

confidence: 99%

Anatomical and Imaging Study on the Optimum Entry Point and Trajectory for Anterior Transpedicular Root Screw Placement into the Lower Cervical Spine

Zhang

Zhao

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To study the optimum entry point and trajectory for anterior transpedicular root screw (ATPRS) placement into the lower cervical spine (LCS), so as to provide a basis for clinical application. Methods. A retrospective analysis of cervical CT images of patients who underwent cervical CT examination in the Spinal Surgery of Ningbo No. 6 Hospital from January 2020 to August 2021 was conducted. The data were obtained and modeled. On the coronal plane, the vertebral body (VB) between the anterior midline of cervical vertebral segments C3-7 and the left P line (by drawing the line parallel to the anterior midline of the VB at the intersection of the anterior edge of the Luschka’s joint and the upper endplate) was equally divided into 9 zones (a-i). The ideal entry point and path of cervical ATPRS were designed and recorded. Additionally, 7 cadaveric specimens were selected, and the screw placement parameters were regenerated according to the above methods for screw placement. Results. Zone i of each segment, with the longest screw length, was the best area for screw placement. In all patients, the horizontal angles of vertebrae C3-7 in zones a, d, and g, zones b, e, and h, and zones c, f, and i showed a gradually decreasing trend. The sagittal angle range of C3-7 in all patients showed a gradually increasing trend in zones a-c, d-f, and g-i. The distance from the anterior midline of C3-7 to the P line increased in all patients, and the distance was longer in males than in females, with statistical significance. Pedicle screws were successfully inserted in all the 7 cadaveric specimens. Conclusions. ATPRS placement can be used for LCS internal fixation, and the precise screw placement parameters can be simulated by the software, which provides theoretical basis for its future clinical application.

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“…Frontiers in Bioengineering and Biotechnology frontiersin.org developing a finite element model would undoubtedly lower the learning cost (Wu et al, 2021) and hence more informative and clearly accessible review articles are required. The computational cost of an FEA model is largely controlled by the mesh density, nonlinear settings, and computing power.…”

Section: Figurementioning

confidence: 99%

Recent advancement in finite element analysis of spinal interbody cages: A review

Wang

2023

Front. Bioeng. Biotechnol.

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Finite element analysis (FEA) is a widely used tool in a variety of industries and research endeavors. With its application to spine biomechanics, FEA has contributed to a better understanding of the spine, its components, and its behavior in physiological and pathological conditions, as well as assisting in the design and application of spinal instrumentation, particularly spinal interbody cages (ICs). IC is a highly effective instrumentation for achieving spinal fusion that has been used to treat a variety of spinal disorders, including degenerative disc disease, trauma, tumor reconstruction, and scoliosis. The application of FEA lets new designs be thoroughly “tested” before a cage is even manufactured, allowing bio-mechanical responses and spinal fusion processes that cannot easily be experimented upon in vivo to be examined and “diagnosis” to be performed, which is an important addition to clinical and in vitro experimental studies. This paper reviews the recent progress of FEA in spinal ICs over the last six years. It demonstrates how modeling can aid in evaluating the biomechanical response of cage materials, cage design, and fixation devices, understanding bone formation mechanisms, comparing the benefits of various fusion techniques, and investigating the impact of pathological structures. It also summarizes the various limitations brought about by modeling simplification and looks forward to the significant advancement of spine FEA research as computing efficiency and software capabilities increase. In conclusion, in such a fast-paced field, the FEA is critical for spinal IC studies. It helps in quantitatively and visually demonstrating the cage characteristics after implanting, lowering surgeons’ learning costs for new cage products, and probably assisting them in determining the best IC for patients.

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A graphical guide for constructing a finite element model of the cervical spine with digital orthopedic software

Cited by 17 publications

References 42 publications

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Anatomical and Imaging Study on the Optimum Entry Point and Trajectory for Anterior Transpedicular Root Screw Placement into the Lower Cervical Spine

Recent advancement in finite element analysis of spinal interbody cages: A review

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