John Jobin D, Yoganandan Narayan, Arun Mike W J, Saravana Kumar G
a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin.
b Department of Engineering Design , Indian Institute of Technology Madras , Chennai , India.
Traffic Inj Prev. 2018 Feb 28;19(sup1):S29-S36. doi: 10.1080/15389588.2017.1403017.
OBJECTIVES: The objective of this study was to investigate the influence of morphological variations in osteoligamentous lower cervical spinal segment responses under postero-anterior inertial loading. METHODS: A parametric finite element model of the C5-C6 spinal segment was used to generate models. Variations in the vertebral body and facet depth (anteroposterior), posterior process length, intervertebral disc height, facet articular process height and slope, segment orientation ranging from lordotic to straight, and segment size were parameterized. These variations included male-female differences. A Latin hypercube sampling method was used to select parameter values for model generation. Forces and moments associated with the inertial loading were applied to the generated model segments. The 7 parameters were grouped as local or global depending on the number of spinal components involved in the shape variation. Four output responses representing overall segmental and soft tissue responses were analyzed for each model variation: response angle of the segment, anterior longitudinal ligament stretch, anterior capsular ligament stretch, and facet joint compression in the posterior region. Pearson's correlation coefficient was used to compute the correlations of these output responses with morphological variations. RESULTS: Fifty models were generated from the parameterized model using a Latin hypercube sampling technique. Variation in response angle among the models was 4° and was most influenced by change in the combined dimension of vertebral body and facet depth, followed by size of the segment. The maximum anterior longitudinal ligament stretch varied between 0.1 and 0.3 and was strongly influenced by the change in the segment orientation. The anterior facet joint region sustained tension, whereas the posterior region sustained compression. For the anterior capsular ligament stretch, the most influential global variation was segment orientation, whereas the most influential local variations were the facet height and facet angle parameters. In the case of posterior facet joint compression, segment orientation was again most influential, whereas among the local variations, the facet angle had the most influence. CONCLUSION: Shape variations in the intervertebral disc influenced segmental rotation and ligament responses; however, the influence of shape variations in the facet joint was confined to capsular ligament responses. Response angle was most influenced by the vertebral body depth variations, explaining greater segmental rotations in female spines. Straighter spine segments sustained greater posterior facet joint compression, which may offer an explanation for the higher incidence of whiplash-associated disorders among females, who exhibit a straighter cervical spine. The anterior longitudinal ligament stretch was also greater in straighter segments. These findings indicate that the morphological features specific to the anatomy of the female cervical spine may predispose it to injury under inertial loading.
目的:本研究的目的是调查在前后向惯性载荷下,下颈椎骨韧带节段形态变化的影响。 方法:使用C5-C6脊柱节段的参数化有限元模型来生成模型。对椎体和关节突深度(前后径)、棘突长度、椎间盘高度、关节突关节突高度和斜率、从前凸到伸直的节段方向以及节段大小的变化进行参数化。这些变化包括男女差异。采用拉丁超立方抽样方法为模型生成选择参数值。将与惯性载荷相关的力和力矩应用于生成的模型节段。根据形状变化中涉及的脊柱组件数量,将这7个参数分为局部或全局参数。对每个模型变化分析代表整体节段和软组织反应的4个输出响应:节段的响应角度、前纵韧带拉伸、前囊韧带拉伸和后部区域的小关节压缩。使用Pearson相关系数计算这些输出响应与形态变化的相关性。 结果:使用拉丁超立方抽样技术从参数化模型中生成了50个模型。模型之间的响应角度变化为4°,受椎体和关节突深度组合尺寸变化的影响最大,其次是节段大小。前纵韧带的最大拉伸在0.1至0.3之间变化,受节段方向变化的强烈影响。前小关节区域承受张力,而后部区域承受压缩。对于前囊韧带拉伸,最有影响的全局变化是节段方向,而最有影响的局部变化是关节突高度和关节突角度参数。在后部小关节压缩的情况下,节段方向再次最有影响,而在局部变化中,关节突角度影响最大。 结论:椎间盘的形状变化影响节段旋转和韧带反应;然而,小关节形状变化的影响仅限于囊韧带反应。响应角度受椎体深度变化的影响最大,这解释了女性脊柱中更大的节段旋转。更直的脊柱节段承受更大的后部小关节压缩,这可能解释了女性鞭打相关疾病发病率较高的原因,女性的颈椎更直。在更直的节段中,前纵韧带的拉伸也更大。这些发现表明,女性颈椎解剖结构特有的形态特征可能使其在惯性载荷下易受损伤。
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