Spinal Compressive Forces in Adolescent Idiopathic Scoliosis With and Without Carrying Loads: A Musculoskeletal Modeling Study

Schmid, Stefan; Burkhart, Katelyn; Allaire, Brett T.; Grindle, Daniel; Bassani, Tito; Galbusera, Fabio; Anderson, Dennis E.

doi:10.3389/fbioe.2020.00159

Cited by 27 publications

(31 citation statements)

References 34 publications

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“…Larger deformity provides larger vertebral rotation in the coronal plane at upper and lower end levels of the scoliotic curve (Figure 2E), which results into larger contribution of the transferred load relatively to the lateral axis in the vertebral reference system (Figure 2E, upper right corner). As concerns the activation of MF and ES muscle, the slightly positive values (similar between groups) of the normalized activity ratio indicate a larger activation in the convex side of the scoliotic curve, in agreement with our previous findings (Barba et al, 2021) and with other numerical and experimental studies (Schmid et al, 2020;Cheung et al, 2005;Kwok et al, 2015). Overall, the biomechanical parameters did not provide a priori information about the risk of curve progression.…”

Section: Discussionsupporting

confidence: 88%

“…At this stage, we thus preferred to limit the simulation to the upright posture, although expected to provide lower spinal loads and muscle activities compared to the motion tasks (Dreischarf et al, 2016). According to that performed in previous similar works (Schmid et al, 2020;Barba et al, 2021), the evaluation of muscle activation as predictor of the scoliosis progression was limited to ES and MF. In this regard, additional groups such as quadratus lumborum, internal obliques, and latissimus dorsi could be considered as potential predictors in future developments simulating the motion of the trunk.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, biomechanical parameters such as trunk muscle activation and intervertebral loading could provide additional advantageous information (Bassani et al, 2017;Schmid et al, 2020). Although not measurable in vivo due to the invasiveness of the procedures, such parameters can be obtained by numerical simulation based on musculoskeletal modelling approach, which allows for calculating the biomechanical loads in assigned kinematic conditions by means of inverse dynamic analysis (Dreischarf et al, 2016;Bassani and Galbusera, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Accounting for Biomechanical Measures from Musculoskeletal Simulation of Upright Posture Does Not Enhance the Prediction of Curve Progression in Adolescent Idiopathic Scoliosis

Bassani

Cina

Ignasiak

et al. 2021

Front. Bioeng. Biotechnol.

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A major clinical challenge in adolescent idiopathic scoliosis (AIS) is the difficulty of predicting curve progression at initial presentation. The early detection of progressive curves can offer the opportunity to better target effective non-operative treatments, reducing the need for surgery and the risks of related complications. Predictive models for the detection of scoliosis progression in subjects before growth spurt have been developed. These models accounted for geometrical parameters of the global spine and local descriptors of the scoliotic curve, but neglected contributions from biomechanical measurements such as trunk muscle activation and intervertebral loading, which could provide advantageous information. The present study exploits a musculoskeletal model of the thoracolumbar spine, developed in AnyBody software and adapted and validated for the subject-specific characterization of mild scoliosis. A dataset of 100 AIS subjects with mild scoliosis and in pre-pubertal age at first examination, and recognized as stable (60) or progressive (40) after at least 6-months follow-up period was exploited. Anthropometrical data and geometrical parameters of the spine at first examination, as well as biomechanical parameters from musculoskeletal simulation replicating relaxed upright posture were accounted for as predictors of the scoliosis progression. Predicted height and weight were used for model scaling because not available in the original dataset. Robust procedure for obtaining such parameters from radiographic images was developed by exploiting a comparable dataset with real values. Six predictive modelling approaches based on different algorithms for the binary classification of stable and progressive cases were compared. The best fitting approaches were exploited to evaluate the effect of accounting for the biomechanical parameters on the prediction of scoliosis progression. The performance of two sets of predictors was compared: accounting for anthropometrical and geometrical parameters only; considering in addition the biomechanical ones. Median accuracy of the best fitting algorithms ranged from 0.76 to 0.78. No differences were found in the classification performance by including or neglecting the biomechanical parameters. Median sensitivity was 0.75, and that of specificity ranged from 0.75 to 0.83. In conclusion, accounting for biomechanical measures did not enhance the prediction of curve progression, thus not supporting a potential clinical application at this stage.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accounting for Biomechanical Measures from Musculoskeletal Simulation of Upright Posture Does Not Enhance the Prediction of Curve Progression in Adolescent Idiopathic Scoliosis

Bassani

Cina

Ignasiak

et al. 2021

Front. Bioeng. Biotechnol.

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“…Schmid et al also observed muscle geometry and activity asymmetry. 142 They reported the predicted muscle volume was generally in line with the literature; the majority of the models had larger erector spinae volumes on the convex side of the curve, and one third had larger volumes on the concave side. However, for the multifidi muscles Schmid et al reported larger volumes on the concave side for about 90% of the models.…”

Section: Methodssupporting

confidence: 70%

“…Asymmetric muscle activity partially agreed with the literature, however differences could be attributed to differences between the curvature of the models and the subjects in the literature. 142 Previous studies have also found that the scoliotic spine experienced greater muscle force asymmetry than a healthy spine. 119 …”

Section: Methodsmentioning

confidence: 96%

Computational modelling of the scoliotic spine: A literature review

Gould¹,

Cristofolini

Davico³

et al. 2021

Numer Methods Biomed Eng

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Scoliosis is a deformity of the spine that in severe cases requires surgical treatment. There is still disagreement among clinicians as to what the aim of such treatment is as well as the optimal surgical technique. Numerical models can aid clinical decision‐making by estimating the outcome of a given surgical intervention. This paper provided some background information on the modelling of the healthy spine and a review of the literature on scoliotic spine models, their validation, and their application. An overview of the methods and techniques used to construct scoliotic finite element and multibody models was given as well as the boundary conditions used in the simulations. The current limitations of the models were discussed as well as how such limitations are addressed in non‐scoliotic spine models. Finally, future directions for the numerical modelling of scoliosis were addressed.

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A multibody simulation of the spine for objectification of biomechanical quantities after VBT: a proof of concept and description of baseline data

Frank,

Pishnamaz,

Ignasiak

et al. 2024

Eur Spine J

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Purpose Vertebral Body Tethering (VBT), an alternative treatment for adolescent idiopathic scoliosis, shows satisfactory post-operative results. However, the biomechanical quantities and consequences after VBT surgery remain largely unknown. Therefore, the aim of this study is to analyze the spinal biomechanics during different motions using a multibody simulation approach. Methods The tether and intervertebral compression forces were simulated in a validated spine model during different physiological movements at different pre-tensions and screw positions, while considering the anatomical muscle and ligament properties. Results The simulations showed that an augmentation of the pre-tension and an alteration of the screw position have both significant impact on the intervertebral compression and tether forces. The forces also vary depending on the movement performed, with the highest tether forces measured during lateral bending. In the upright position, with a pre-tension of 200 N, the maximum compression force increases by up to 157% compared to the untethered maximum compression force. The screw position can lead to large differences in the distribution of forces in the spine. Conclusion The biomechanical data provide a first impression of the forces that occur along the spine during various physiological movements and are consistent with published clinical data. Forces are not evenly distributed along the spine, with higher lumbar forces. The tether forces reach values during lateral bending that can potentially destroy the tether´s integrity and thus may explain the common post-operative complication, namely tether breakage. The results of the model can therefore have an impact on future directions for improved surgical VBT treatment.

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Spinal Compressive Forces in Adolescent Idiopathic Scoliosis With and Without Carrying Loads: A Musculoskeletal Modeling Study

Cited by 27 publications

References 34 publications

Accounting for Biomechanical Measures from Musculoskeletal Simulation of Upright Posture Does Not Enhance the Prediction of Curve Progression in Adolescent Idiopathic Scoliosis

Accounting for Biomechanical Measures from Musculoskeletal Simulation of Upright Posture Does Not Enhance the Prediction of Curve Progression in Adolescent Idiopathic Scoliosis

Computational modelling of the scoliotic spine: A literature review

A multibody simulation of the spine for objectification of biomechanical quantities after VBT: a proof of concept and description of baseline data

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