Grünwald Alexander T D, Roy Susmita, Alves-Pinto Ana, Lampe Renée
Orthopaedic Department, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Markus Würth Professorship, Technical University of Munich, Munich, Germany.
PLoS One. 2021 Feb 10;16(2):e0243736. doi: 10.1371/journal.pone.0243736. eCollection 2021.
Adolescent idiopathic scoliosis, is a three-dimensional spinal deformity characterized by lateral curvature and axial rotation around the vertical body axis of the spine, the cause of which is yet unknown. The fast progression entails regular clinical monitoring, including X-rays. Here we present an approach to evaluate scoliosis from the three-dimensional image of a patient's torso, captured by an ionizing radiation free body scanner, in combination with a model of the ribcage and spine. A skeletal structure of the ribcage and vertebral column was modelled with computer aided designed software and was used as an initial structure for macroscopic finite element method simulations. The basic vertebral column model was created for an adult female in an upright position. The model was then used to simulate the patient specific scoliotic spine configurations. The simulations showed that a lateral translation of a vertebral body results in an effective axial rotation and could reproduce the spinal curvatures. The combined method of three-dimensional body scan and finite element model simulations thus provide quantitative anatomical information about the position, rotation and inclination of the thoracic and lumbar vertebrae within a three-dimensional torso. Furthermore, the simulations showed unequal distributions of stress and strain profiles across the intervertebral discs, due to their distortions, which might help to further understand the pathogenesis of scoliosis.
青少年特发性脊柱侧弯是一种三维脊柱畸形,其特征为脊柱侧弯以及围绕脊柱垂直身体轴的轴向旋转,病因尚不明确。快速进展需要定期进行临床监测,包括X光检查。在此,我们提出一种方法,通过无电离辐射的人体扫描仪获取患者躯干的三维图像,并结合胸廓和脊柱模型来评估脊柱侧弯。利用计算机辅助设计软件对胸廓和脊柱的骨骼结构进行建模,并将其用作宏观有限元方法模拟的初始结构。基本的脊柱模型是针对直立姿势的成年女性创建的。然后使用该模型模拟患者特定的脊柱侧弯形态。模拟结果表明,椎体的侧向平移会导致有效的轴向旋转,并能重现脊柱弯曲。因此,三维身体扫描和有限元模型模拟相结合的方法可提供有关三维躯干内胸椎和腰椎位置、旋转和倾斜度的定量解剖学信息。此外,模拟结果显示,由于椎间盘变形,应力和应变分布在椎间盘上不均匀,这可能有助于进一步了解脊柱侧弯的发病机制。