Yoganandan Narayan, Moore Jason, Humm John, Pintar Frank, Baisden Jamie, Barnes David, Loftis Kathryn
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
SURVICE Engineering, Belcamp, Maryland.
Traffic Inj Prev. 2022;23(sup1):S26-S31. doi: 10.1080/15389588.2022.2110589. Epub 2022 Sep 12.
The transmission of impact loading from the seat-to-pelvis-to-lumbar spine in a seated occupant in automotive and military events is a mechanism for fractures to these body regions. While postmortem human subject (PMHS) studies have replicated fractures to the pelvis or lumbar spine using isolated/component models, the role of the time factor that manifests as a loading rate issue on injuries has not been fully investigated in literature. The objective of this study was to explore the hypothesis that short duration pulses fracture the pelvis while longer pulses fracture the spine, and intermediate pulses involve both components. Unembalmed PMHS thoracolumbar spine-pelvis specimens were fixed at the superior end, and a six-axis load cell was attached. The specimens were mounted on a vertical accelerator, and noninjury and injury tests were conducted by applying short, medium, or long pulses with 5, 15, or 35 ms durations, respectively. Peak axial, shear and resultant forces were obtained. Injuries were documented using posttest x-ray and computed tomography images and scaled using the AIS (2015). The mean age, stature, weight, body mass index, and BMD of twelve specimens were 64.8 ± 11.4 years, 1.8 ± 0.01 m, 83 ± 13 kg, 26.7 ± 5.0 kg/m, and 114.5 ± 21.3 mg/cc, respectively. For the short, long, and medium duration pulses, the mean resultant forces were 5.6 ± 0.9 kN, 5.9 ± 0.94 kN, and 5.4 ± 1.8 kN, and time durations were 4.8 ± 0.5 ms, 16.3 ± 7.3 ms, and 34.5 ± 7.5 ms, respectively. For the short pulse, pelvis injuries were more severe in 3 out 4 specimens, for the medium pulse, they were distributed between the pelvis and spine, and for the long pulse, spine injuries were more severe in 3 out of 4 specimens. While acknowledging the limitations of the sample size, the results of this study support the hypothesis of the time variable in the tradeoff between pelvis and spine injuries with pulse duration. The tradeoff pattern is attributed to mass recruitment: short pulse biases injuries to pelvis while limiting spinal injuries, and the opposite is true for the longer pulse, thus supporting the hypothesis. It is important to account for the time variable in injury analysis.
在汽车和军事活动中,就座乘客从座椅到骨盆再到腰椎的冲击载荷传递是这些身体部位发生骨折的一种机制。虽然尸体人体受试者(PMHS)研究已经使用孤立/组件模型复制了骨盆或腰椎骨折,但文献中尚未充分研究表现为加载速率问题的时间因素对损伤的作用。本研究的目的是探讨以下假设:短持续时间脉冲会导致骨盆骨折,而长脉冲会导致脊柱骨折,中等脉冲会同时涉及这两个部位。未防腐处理的PMHS胸腰椎 - 骨盆标本固定在上端,并连接一个六轴测力传感器。将标本安装在垂直加速器上,分别施加持续时间为5、15或35毫秒的短、中、长脉冲进行非损伤和损伤测试。获得了轴向、剪切和合力峰值。使用测试后的X光和计算机断层扫描图像记录损伤情况,并根据AIS(2015)进行分级。十二个标本的平均年龄、身高、体重、体重指数和骨密度分别为64.8±11.4岁、1.8±0.01米、83±13千克、26.7±5.0千克/平方米和114.5±21.3毫克/立方厘米。对于短、长和中等持续时间的脉冲,平均合力分别为5.6±0.9千牛、5.9±0.94千牛和5.4±1.8千牛,持续时间分别为4.8±0.5毫秒、16.3±7.3毫秒和34.5±7.5毫秒。对于短脉冲,4个标本中有3个骨盆损伤更严重;对于中等脉冲,损伤分布在骨盆和脊柱之间;对于长脉冲,4个标本中有3个脊柱损伤更严重。尽管承认样本量存在局限性,但本研究结果支持了在骨盆和脊柱损伤与脉冲持续时间之间的权衡中时间变量的假设。这种权衡模式归因于质量募集:短脉冲使损伤偏向骨盆,同时限制脊柱损伤,而长脉冲则相反,从而支持了该假设。在损伤分析中考虑时间变量很重要。