Tropiano P, Thollon L, Arnoux P J, Huang R C, Kayvantash K, Poitout D G, Brunet C
Laboratoire de Biomécanique Appliquée, UMRT24 INRETS/University of Méditerranée Faculty of Medicine. Fac. Médecine Nord, Marseille, France.
Spine (Phila Pa 1976). 2004 Aug 15;29(16):1709-16. doi: 10.1097/01.brs.0000135840.92373.5c.
STUDY DESIGN: In the field of numerical simulation, the finite element method provides a virtual tool to study human tolerance and postulate on potential trauma under crash situations, particularly in case of whiplash trauma. OBJECTIVES: To show how medical and biomechanical interpretations of numerical simulation can be used to postulate on human injuries during crash situations. This methodology was applied to whiplash trauma analysis. A detailed analysis of kinematics of joints, stress level in hard tissues, and strain level in soft tissues was used to postulate on chronology and patterns of injury. Data were compared with published biomechanical and clinical studies of whiplash. SUMMARY OF BACKGROUND DATA: Although many in vitro and in vivo studies have been conducted to investigate whiplash cervical injury, and despite the number of finite element models developed to simulate the biomechanical behavior of the cervical spine, to date, there are only limited finite element models reported in the literature on the biomechanical response of the whole cervical spine in these respects. METHODS: A complete finite element model of the human body (HUMOS) build in a sitting position in a car environment was created to investigate injury mechanisms and to provide data for automotive safety improvements. It includes approximately 50,000 elements, including descriptions of all bones, ligaments, tendons, skin, muscles, and internal organs. A 15-g whiplash injury was simulated with the HUMOS model. The model predicted cervical motion segment kinematics, deformations of disks and ligaments, and stresses in bone. Model output was then compared with experimental and clinical whiplash literature. RESULTS: In term of kinematics during the chronology of whiplash, two injury phases were identified: the first was hyperextension of the lower cervical spine (C6-C7 and C5-C6) and mild flexion of the upper cervical spine(C0-C4). The amount of upper cervical flexion was 15 degrees from C0 to C4. The second phase was hyperextension of the entire cervical spine. Potential patterns of ligamentous injuries were observed; the anterior longitudinal ligament experienced the most strain (30%) at the lower cervical spine at the time of lower cervical extension and the interspinous ligament experienced the most strain (60%) at the time of upper cervical flexion. Von Mises stresses in bone do not exceed 15 Mpa, which is largely under injury levels reported in the literature. CONCLUSIONS.: This study reports a methodology to describe and postulate on human injuries based on finite element model analysis. The output of the HUMOS model in the context of whiplash shows a strong correlation with clinical and experimental reported data. HUMOS shows promise for the modeling of other types of trauma as well.
研究设计:在数值模拟领域,有限元方法提供了一种虚拟工具,用于研究人体耐受性并推测碰撞情况下的潜在创伤,尤其是在挥鞭样损伤的情况下。 目的:展示如何利用数值模拟的医学和生物力学解释来推测碰撞情况下的人体损伤。该方法应用于挥鞭样损伤分析。通过对关节运动学、硬组织应力水平和软组织应变水平进行详细分析,来推测损伤的时间顺序和模式。将数据与已发表的关于挥鞭样损伤的生物力学和临床研究进行比较。 背景数据总结:尽管已经进行了许多体外和体内研究来调查挥鞭样颈椎损伤,并且尽管已经开发了许多有限元模型来模拟颈椎的生物力学行为,但迄今为止,文献中关于整个颈椎在这些方面的生物力学反应的有限元模型报道仍然有限。 方法:创建了一个处于汽车环境坐姿的人体完整有限元模型(HUMOS),以研究损伤机制并为汽车安全改进提供数据。它包括大约50000个单元,涵盖了所有骨骼、韧带、肌腱、皮肤、肌肉和内部器官的描述。使用HUMOS模型模拟了15g 的挥鞭样损伤。该模型预测了颈椎运动节段的运动学、椎间盘和韧带的变形以及骨骼中的应力。然后将模型输出与实验性和临床性挥鞭样损伤文献进行比较。 结果:在挥鞭样损伤的时间顺序方面,确定了两个损伤阶段:第一个阶段是下颈椎(C6 - C7和C5 - C6)的过伸和上颈椎(C0 - C4)的轻度屈曲。从C0到C4的上颈椎屈曲量为15度。第二个阶段是整个颈椎的过伸。观察到了潜在的韧带损伤模式;在前纵韧带在下颈椎伸展时在下颈椎处承受的应变最大(30%),棘间韧带在上颈椎屈曲时承受的应变最大(60%)。骨骼中的冯·米塞斯应力不超过15 Mpa,这在很大程度上低于文献报道的损伤水平。 结论:本研究报告了一种基于有限元模型分析来描述和推测人体损伤的方法。HUMOS模型在挥鞭样损伤背景下的输出与临床和实验报道的数据显示出很强的相关性。HUMOS在模拟其他类型创伤方面也显示出前景。
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