Influence of morphological variations on cervical spine segmental responses from inertial loading

John, Jobin; Yoganandan, Narayan; Arun, Mike W. J.; Kumar, Girish

doi:10.1080/15389588.2017.1403017

Cited by 23 publications

(8 citation statements)

References 58 publications

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“…Advances in computational power have expedited the FE model development process, and patient-specific FE models have emerged that incorporate the unique anatomical features of each patient [ 9 , 26 - 28 ]. In principle, patient-specific models will account for sex-specific morphological differences.…”

Section: Discussionmentioning

confidence: 99%

“…Consequent to their smaller size, female cervical vertebrae have smaller intersegmental contact areas as compared to males, which is predicted to result in less intrinsic stability and greater motion in response to force [1][2]. Indeed, John et al demonstrated segmental spinal motion is significantly influenced by variations in vertebral body size, specifically vertebral body depth [9]. Consistent with these observations and predictions, some [18][19] but not all [20] studies report the range of voluntary cervical spine motion is greater in females than males, even though voluntary neck muscle strength is significantly less in females [3,21].…”

Section: Sex-specific Intubation Biomechanicsmentioning

confidence: 99%

“…Recent studies of head, neck, and cervical spine morphology [ 1 - 4 ] and tissue material properties [ 5 - 6 ] indicate adult male and female cervical spines are significantly different [ 7 ]. In finite element (FE) modeling studies, these differences result in sex-specific cervical spine kinematics in response to standard loads [ 8 ] and may explain sex-specific cervical spine injury patterns in response to inertial loading [ 9 ]. Direct laryngoscopy and endotracheal intubation is a common clinical procedure in which a load is applied to the cervical spine.…”

Section: Introductionmentioning

confidence: 99%

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Sex-Specific Intubation Biomechanics: Intubation Forces Are Greater in Male Than in Female Patients, Independent of Body Weight

Hindman¹,

Dexter²,

Gadomski³

et al. 2020

Cureus

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Background Studies of head, neck, and cervical spine morphology and tissue material properties indicate that cervical spine biomechanics differ between adult males and females. These differences result in sex-specific cervical spine kinematics and injury patterns in response to standardized loading conditions. Because direct laryngoscopy and endotracheal intubation require the application of a load to the cervical spine, intubation biomechanics should be sex-specific. The aim of this study was to determine if intubation forces during direct laryngoscopy differ between male and female patients and, if so, is the difference independent of body weight. Methods We pooled original data from three previously published adult clinical intubation studies that used methodologically reliable intubation force measurements (measured total laryngoscope force applied to the tongue, and force values were insensitive to or accounted for other laryngoscope blade forces). All patients had undergone direct laryngoscopy and orotracheal intubation with a Macintosh 3 blade under general anesthesia. Patient data included sex, age, height, weight, and maximum intubation force. Least squares multivariable linear regression was performed between the dependent variable (maximum intubation force) and two independent variables (patient sex and patient weight). A third term was added for the interaction between patient sex and weight. Results Among all patients (males n=42, females n=59), the median intubation force was 42.2 N (25 th to 75 th percentiles: 31.5 to 57.4 N). While controlling for patient body weight, intubation force differed between the sexes; P=0.011, with greater intubation force in male patients. While controlling for patient sex, there was a positive association between patient body weight and intubation force; P=0.009. In addition, there was a significant interaction between patient sex and weight; P=0.002, with intubation force in male patients having greater dependence on body weight. The difference in intubation force between male and female patients who had the same body weight exceeded 5 N when body weight exceeded 75 kg, and intubation force differences between male and female patients increased as patient body weight increased. Additional analyses using robust regression and using body mass index instead of weight provided comparable results.

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Section: Discussionmentioning

confidence: 99%

Section: Sex-specific Intubation Biomechanicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sex-Specific Intubation Biomechanics: Intubation Forces Are Greater in Male Than in Female Patients, Independent of Body Weight

Hindman¹,

Dexter²,

Gadomski³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…[ 23 41 42 ] The present model was developed using multiblock technique. [ 43 44 ] The differentiation of the vertebrae into different blocks allows the user to independently control the regional anatomy of the spine, thus achieving the patient-specific spine model using the baseline finite-element model. It should be noted that the baseline model was used for the current analysis of ROMs and osteophytes were not included.…”

Section: Discussionmentioning

confidence: 99%

Effects of different severities of disc degeneration on the range of motion of cervical spine

Yoganandan

Choi

Purushothaman

et al. 2020

J Craniovert Jun Spine

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Aims and Objectives: The human spine degenerates with age. Intervertebral disc degeneration occurs in the cervical spine. The objective of this study is to determine the effects of degenerative disc diseases on the range of motion (ROM) of the human cervical spinal column using a validated finite-element model. Materials and Methods: The validated intact and healthy C2–T1 finite-element model simulated the cortical shell, cancellous core, posterior elements of the vertebrae, and spinal ligaments (longitudinal, capsular, spinous and ligamentum flava, and nucleus and annulus of the discs). Three different stages of the disc disease, that is, mild, moderate, and severe, were simulated at the C5–C6, C6–C7, and C5–C6–C7 discs, respectively, and they were termed as upper single level, lower single level, and bi-level (BL) models, respectively. The material properties and geometry of the disc(s) were altered to simulate the different stages of degeneration. The external mechanical loading was applied in the sagittal mode, via flexion–extension motions and the magnitude was 2.0 Nm for each mode. They were applied to each of the healthy and disc degeneration models, and for each of the three severities of degeneration. The ROM at adjacent and index levels was extracted and normalized with respect to the healthy (baseline) spine. Results: A nonuniform distribution in the ROM was found for different disc degeneration states, segmental levels, and flexion–extension loading modes. The specific results for each and level are reported in the results section of the paper. Conclusion: Closer follow-up times may be necessary in symptomatic patients with progressive disease, especially with BL involvements.

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“…( 2017 ) Frictionless Linear elastic: , = 0.4 John et al. ( 2018 ) Linear elastic: , = 0.3 Kang et al. ( 2010 ) Linear elastic: , = 0.45 Lee et al.…”

Section: Methodologies For Facet Joints Modelsmentioning

confidence: 99%

Biomechanical modelling of the facet joints: a review of methods and validation processes in finite element analysis

Mengoni

2020

Biomech Model Mechanobiol

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There is an increased interest in studying the biomechanics of the facet joints. For in silico studies, it is therefore important to understand the level of reliability of models for outputs of interest related to the facet joints. In this work, a systematic review of finite element models of multi-level spinal section with facet joints output of interest was performed. The review focused on the methodology used to model the facet joints and its associated validation. From the 110 papers analysed, 18 presented some validation of the facet joints outputs. Validation was done by comparing outputs to literature data, either computational or experimental values; with the major drawback that, when comparing to computational values, the baseline data was rarely validated. Analysis of the modelling methodology showed that there seems to be a compromise made between accuracy of the geometry and nonlinearity of the cartilage behaviour in compression. Most models either used a soft contact representation of the cartilage layer at the joint or included a cartilage layer which was linear elastic. Most concerning, soft contact models usually did not contain much information on the pressure-overclosure law. This review shows that to increase the reliability of in silico model of the spine for facet joints outputs, more needs to be done regarding the description of the methods used to model the facet joints, and the validation for specific outputs of interest needs to be more thorough, with recommendation to systematically share input and output data of validation studies.

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Influence of morphological variations on cervical spine segmental responses from inertial loading

Cited by 23 publications

References 58 publications

Sex-Specific Intubation Biomechanics: Intubation Forces Are Greater in Male Than in Female Patients, Independent of Body Weight

Sex-Specific Intubation Biomechanics: Intubation Forces Are Greater in Male Than in Female Patients, Independent of Body Weight

Effects of different severities of disc degeneration on the range of motion of cervical spine

Biomechanical modelling of the facet joints: a review of methods and validation processes in finite element analysis

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